HOME BIRTH VS HOSPITAL | Pros and Cons, Safety, FAQs, Tips, + Personal Experience!

Wondering about the pros and cons of a home birth vs hospital birth? Sharing my tips and personal experience with both a positive hospital birth and a positive home birth!

Plus discover my #1 question to ask an OB-GYN, hospital, and midwife when putting together your labor and delivery birth team, pros and cons for each setting (especially with a toddler!), and things to consider when discussing whether or not a home birth is safe.

This is by no means medical advice, but simply my experience and to help you formulate questions for your care providers!

Is a home birth safe?

There are facts and then there are opinions so I'll answer this a couple of ways:

My OPINION is giving birth wherever YOU feel safest and most supported is one of the biggest dictating factors of how safe and comfortable your birthing experience will ultimately be if you're a low risk pregnancy.

The body needs to feel safe in order to open and relax and do exactly what it was built to do.

Statistically, PLANNED home births – and that’s an important word because not all the statistics you google will factor that in – are generally considered just as safe and healthy. But with that said, there’s a lot of nuance to that.

Important distinctions in the conversation on safety:

Are we defining SAFE as just maternal mortality and infant mortality or are we defining safe as few interventions as possible?

While mortality is obviously the biggest defining safety factor, too many interventions can lead to lifelong health issues for both mother and baby and should be considered in the safety conversation with your care provider.

Here are just a few common interventions to discuss with your care provider and fully understand the implications of:

• Cervical checks
• Membrane Sweep
• Medically unnecessary induction
• Ultrasounds (particularly 4D or more than 2-3 max unless medically necessary)
• Pitocin
• Epidural
• GBS status
• Alternatives to glucose drink for glucose test
• Basically anything being put into your body or done to your body requires an understanding of long term risks!

@essentiallyerin__ on instagram is a nurse, she covers this topic well in my opinion with lots of studies and research linked.

I think she does a good job talking about the cascade of interventions that can happen in a hospital setting, which can have long lasting implications, and the difference between midwifery vs. traditional ob-gyn care on this Happy Home Birth podcast episode too if you want to go deeper into the nuance of that.

How did you decide on a home birth? From C-section to hospital to home birth…

I kind of always wanted to do a home birth for as long as I could remember…

Then in my early 20s when I got together with my husband, his mom had me convinced I wanted to have a C-section.

One day I was talking with a friend who was about a decade older than me, with multiple kids, and telling her many fears about being pregnant I had and I was planning to do a c-section when I had kids – and I’ll never forget her face.

We were in the bathroom, she turned around and looked me dead in the eye and said, “what? are you sure about that? You’ll have just given a baby why would you electively have major surgery you’ll need to recover from on top of healing from having a baby”

And dang that question hit me like a thunderbolt…

So fast forward, 6 our 7 year laters, I’m pregnant, and her words ran through me. I just so happened to find out I was pregnant the same month I was due for my annual ob-gyn appointment so I told them I was pregnant, of course they verified it, and then I got my first ultrasound that same day.

It was all exciting and they scheduled me to come back a month later for a prenatal visit.

My ob-gyn at the time was actually the doctor who delivered me. And at that second appointment they handed me a bill for like $15,000 to start a payment plan for. And I remember freaking out saying I wouldn’t pay it because I didn’t know if I wanted a home birth or hospital birth yet.

We hadn’t talked about ANYTHING at this point. It was literally like “oh you’re here for your annual, and your pregnant, here’s an ultrasound, take a prenatal, read “what to expect’ see you in a month.

I met with the other doctor in the practice for this appointment, who was nice enough. And I remember he started telling me how unsafe home births were and I remember asking him what his C-section rate was and all he said to me was “I’ll do everything in my power to see that you don’t need a C-section.” And I just didn’t believe him.

At my first appointment I ran into a couple who I had gone to high school with and between that appointment and this one they had their baby and it was a C-section and I remember just being like something doesn’t feel right here, he didn't give me his number actually…

I think he sensed my apprehension so after the appointment he had me go across the street to the hospital for a tour and to get an idea of what it'd be like.

We went over there, and within 30 seconds of the tour, I remember looking at the “triage” room you wait in while they decide if they are going to admit you or not and just being like that’s a hard no for me.

Which actually REALLY surprised me since this was the hospital I was born in, the hospital I volunteered at as a teenager, and the hospital I had generally positive memories of.

The other hospital in our area is where my dad spent weeks in the ICU and before dying at hospice a few days after the transfer. So for obvious reasons I wasn't thrilled about giving birth there…

Home birth was very much on my heart still at that time. Ultimately though I just didn’t have any support. Everyone in our family is either a nurse or a doctor or married to one or their kid is one. We have 3 doctors, 1 med student, and 3 nurses around us.

Since not even my husband was on board with a homebirth at the time, we found a midwife, did the tour at the other hospital, which was night and day different, and I felt as good about things as I could. 

Hospital birth

I truly has the most Positive Natural Birth Story At A Hospital as anyone could have.

My L&D nurse was truly an angel, she even visited me in postpartum and prayed over me and I still thank God for her being with me.

But, while in labor, I remember I was having a very primal moment, I had the rebozo over the little bar and I remember just roaring baby out and this other nurse walked in the room and made eye contact with me and looked shocked? horrified? scared? I don't know, but she immediately walked out. I remember just feeling like an animal on display and didn’t like that feeling at all.

#1 Question to Ask OB-GYN + Hospital:

“What is your C-section rate? “

I think the national average is 30% – but I personally wouldn't feel comfortable with a care provider with a rate higher than 10%.

Asking additional questions about VBACs and how they handle going over 40 weeks are all really important too and will give you an idea about the type of care provider you're hiring. The idea basically is that you obviously want to deliver baby safely, but you also want to make sure that your care provider doesn't push interventions too soon as increased interventions are often related to increased need for a C-section.

It's a fine line and nuanced between too much care leading to negative experiences and too little care leading to negative experiences.

NOTE: You need to ask the hospital this while on a tour as well incase your OB-GYN isn't delivering your baby!

#1 Question to Ask Midwife:

“What is your transfer rate?”

You don't want a midwife who transfers over the littlest thing, but you also don't want a midwife that is going to push things into an unsafe territory.

In my experience, the latter typically doesn't happen unless the mother asks the midwife to deliver at home no matter what.

How To Get Husband On Board With A Home Birth:

My husband got on board with the homebirth after the hospital birth experience. He really did NOT like the hospital experience. After baby was born, he felt like an outsider watching, versus actually being the dad and a part of it all. And obviously sleeping on the hospital pull out bed isn't comfortable.

My first also came so quickly after we got to the hospital that they didn't even finish admitting me.

My friend has a similar first birth, who gave birth on accident at home with her second the week after I had my first. So for us, it felt like a VERY REAL possibility I wouldn't get to a hospital in time for a second baby since they tend to come faster. And I knew a few other people who had their second baby accidentally at home at the time.

For us, we felt safer and more in comfortable being at home already and not having to worry about where my toddler would go or getting there in time.

Not everyone will feel like that. And don't get me wrong, having a homebirth with a toddler has its own challenges.

What it's like having a home birth with a toddler…

I constantly needed to remember to slow down and have boundaries to care for myself. I remember constantly thinking “most other woman are still in the hospital for these 2-3 days with food being brought to them and no toddler bouncing in and out.” So I really had to shift my mentality to honor that.

Per my midwife's suggestion, I followed the 5 days in the bed, 5 day around the bed, and 5 days around the house suggestion. But again, with a toddler, I probably pushed it a little further than I should've especially since I had set a spare bed up in our playroom so “in the bed” was in her playroom.

How to choose birth team? Doula's necessary? 

• We have a beautiful place here for pregnancy support and education. They have classes, an in-house webster trained chiropractor, doulas, all that good stuff. I worked with them with my first baby and they were just so amazing, I took hypnobirthing there for my first pregnancy, and so this time around, I knew I wanted the same doula and I asked them for home birth midwife recommendations. 

I'd see if you have something like this in your area. If you can't find it, start calling birth centers, even if you plan to do a hospital birth, and ask about webster trained chiropractors and doulas.

• My hospital birth midwife because she was generally considered one of the best for a mom centered hands off approach
• I chose my home birth midwife simply because I trusted her to get my baby out safely. There was a review that she resuscitated a baby – and it was funny because the review was meant to be negative, but that was exactly why I chose her. I wanted someone I knew had the skills to navigate as much as humanly possible and throughout my pregnancy I kept meeting women who had used her and she got them through some difficult situations that continued to reaffirm my decision.

Neither were the overly maternal, warm, lovey dovey type of midwife. My home birth midwife was actually very matter of fact which I appreciated.

I had some situations in my pregnancy that I had to make some non traditional choices with and she was just like “here is the standard level of care, here are the options available to you and the risks of them” and that was exactly what I needed in a midwife this time.

My doula was the ultra compassionate, gentle touch I needed but both are so fabulous at putting the power back into my hands which is truly the most important thing in the sacred passage of motherhood.

Hiring a doula is something I 10/10 recommend

Especially if doing a homebirth. Even with how quickly my babies came, my doula was so much more than a birth support in the room at the time of delivery.

I had hard moments in pregnancy that my doula talked me through and helped me formulate questions I didn’t have words for yet.

I knew if my toddler ended up being awake or needing something during the birth, she could help with that if I didn’t want my husband to leave.

She’s been my unofficially photographer at both births.

When I’ve gone over 40 weeks with both births she has helped me get labor induction massages, she got my chiropractor to adjust me while in labor on a Sunday. I mean it’s all those little things. And if you have family to help with that, then that’s amazing. But I think even if you have supportive family it can be nice to just have someone who does this regularly and fills in the gaps that even the most well intentioned family can miss the mark on. 

How was this pregnancy different than your last?

Which I guess leads me to a short tangent about pregnancy and giving birth. I heard Kori Meloy talk about her second pregnancy and delivery as this redemptive story for her of really owning the birthing experience, not just transferring care to an expert.

Owning the birth experience, not just transferring care.

And I think that was a big lesson I felt I needed to heal from my first birth and why I think I got into some of the difficult choices I did this pregnancy.

You know it’s so easy to want to just look at the doctor or midwife and have them tell you what to do. But that's not what parenthood is actually like at all, and you start parenting the moment you become pregnant…

When I look back on my first baby, having taken that approach of looking to the professionals for the answers/what to do, there are many things I wish I would’ve been more educated and informed on, trusted my instincts on and/or questioned more.

This birth I think really pushed my back against a wall in both learning to ask for help and accept it; as well as question things.

It pushed me to soften in areas I previously was too hard and harden in areas I previously was too soft. Which I think if you’re recovering from any sort of trauma or people pleasing you can relate to on some level. 

What do you need for a home birth vs hospital?

Diapers! Unlike at the hospital, you don't have diapers delivered to your room!

You also may want to have a thermometer on hand, scale, and stethoscope.

At the hospital baby's vitals are constantly being checked and it does take a couple of days for them to regulate their own temperature, so lots of skin to skin time is beneficial. If you're nervous you can have a thermometer on hand to check their temp regularly too, and you'll obviously use that beyond this early postpartum period.

I also liked having this baby scale for weighted feeds and to keep an eye on baby's weight through the first few months.

Lastly, having a stethoscope so you know what your baby's lungs sound like when clear, in case a problem ever arises, is another great tool to have at home. This is actually beneficial for any family member at any point in life, you just want to know what your family members healthy heart and breathing sounds like as a general rule of motherhood in my opinion.