Midwife/Home birth compared to Hospital Birth

18 posts / 0 new
Last post
Joined: 11/01/11
Posts: 143
Midwife/Home birth compared to Hospital Birth

I have a choice. I haven't met the one midwife in the area yet. This being my first pregnancy I need some advice. I haven't told my family yet. They will find out at Thanksgiving in person, so I need some advice from others.

I am going to the obgyn currently and have an appointment to go over blood work on Monday. I wanted to create a list of questions to ask them and then I can use their answers and the midwife's answer and kind of compare their answers. I need some help coming up with questions, too.

Apparently I need lots of help this morning. Any advice would be wonderful. Thank You!!

lexirunner's picture
Joined: 05/10/06
Posts: 460

I don't have any advice, but I'll be watching for what others say because I'm also on the fence about an OB or midwife. I'm also seeing my (new) OB for now, but don't really feel like I need to stay with her. Sorry that didn't help you out at all!

greenmylife's picture
Joined: 10/24/11
Posts: 355

I have never done a home birth so I dont know. I know that the conventional advice is that your "birth plan" is a felxible map to help you. So, while we may say, "no pain meds" or this or that, we are suposed to give ourselves flexibility to change our minds if we need. For that reason, I will be going to a hospital. I think it is less comfortable, but safer for mommy and baby in case of complications- more flexible - and overall more staff support.

My mother did a home birth with my younger brother. It was a very bad idea. She lost too much blood, the cord was wrapped around his neck, and he was breach. Also, was 11 lbs. I know if she could have done it different she would have. It was scary for her, scary for my Dad, and scary for me and my sisters.

I hope that helps provide at least one perspective!

e123vg's picture
Joined: 07/27/06
Posts: 61

i also opt for hospital births. you never know what could go wrong. you can also choose if you want an iv or pain meds. i opt for no pain meds or iv. although with my girls i was only in labor for 3 hours and only 1 and a half hours for my boys. so i'm never in pain as long as most women. i also bring my own blanket, pillows and comforts of home. if this is your first chlid chances are you'll go over due a week and be in labor atleast 24 hours.

for what it's worth my sil tried homebirth with her first child chickened out when labor hit and ran to the hospital.
she managed a homebirth with her second but it was far from pain free or stress free. she sat in a warm tub and became immobile from the pain until an hour after baby was born.

boilermaker's picture
Joined: 08/21/02
Posts: 1984

I've had two hospital births and two home births. I'm planning to do this one at home, too.

For me, there is no comparison. But I think this choice is to each mother and each family. I honestly feel safer at home and am very comfortable with the care I receive from my professional/licensed midwife.

I'd encourage you to check out the Birthing Naturally board here on pg. org-- as they have tons of resources.

The reasons I choose homebirth are:
* When I birth at home, I have two care providers entirely focused on me and my baby. They don't leave. They don't duck out to check on other patients, they are only there for me. It is amazing. When I had my hospital births I was left alone with dh and monitors and people would come in and not really even talk to me, but they would look at my monitor strip and the charts. It was weird to me-- and very awkward.
* My MW carries the same medical equipment that my hospital does and can deal with emergencies appropriately and quickly. I live within minutes of our hospital, so if I needed to transfer, I'm confident we could do so quickly and at the first sign of trouble. She isn't passionate about homebirth-- she is passionate about healthy babies and moms. There is a big difference IMO.
* I feel my baby is safer. Nobody takes the baby from me. We are not exposed to germs and bacteria that are present within the hospital. There are no other patients down the hall crying out. It is my home. Where I am most comfortable, and this translates into better health and a better welcome to the world for my baby IMO. They don't get plopped into a plastic bin, pushed around hospital hallways and poked for no reason. They are welcomed with warmth and love by people who've been waiting months for them to arrive. It is awesome.

The midwifery model of care of very different from OB care-- and I prefer the midwifery model. We focus more on nutrition, overall health, preparation, emotional issues, etc. My appointments with her are a full hour. That is a full hour of her with me, not waiting around alone. We talk about everything relating to my health, from my relationships to how much water I've been drinking to how I'm feeling about the upcoming birth. It is just different. I say this after having an OB attend my first two hospital births. There is no comparison.

Do your homework and make the decision that is right for you. I don't think there is a "right" way to have a baby, but I've found that there is a way that I prefer. Good luck!

sarahsunshine's picture
Joined: 11/29/06
Posts: 1462


I have never had a hospital birth, by I echo everything that boilermaker said about home births.

I would add to that that:
1) stress is the number 1 cause of something going wrong (I don’t have literature to site right now, but it’s easy to find). Therefore, birthing where you are most comfortable will give you the best result.
2) It takes 15-20 minutes to prep an operating room whether you are in the hospital or not (you have to find doctors, nurses, and brief them, set up equipment, etc…). If you require an emergency c-section, If you live within 15-20 minutes of the hospital and have a knowledgeable caregiver, you will get the same time to the operating room as if you are in the hospital.
3) If something is to go seriously wrong, the midwife will have ample time for warning and opportunity to transfer before it gets to the critical stage. In such a situation, she (he) will tell you that you need to get to the hospital.
4) If you are really trying for a drug-free birth, it will be a lot more likely to happen if there are no drugs available to you and it’s not an option. For my first birth, I didn’t want to, but I would have caved if I was at the hospital. It was not an option, so I had to use what was available to me (meditation, stretching, positions, adrenalin, personal strength) to move through the pain. Once I accepted that, it wasn’t bad. I probably wouldn’t have got to that point if the option of pain medication was there.
5) I would never underestimate the value of being able to be in a location where you know everyone, you know the location of everything, and you are comfortable. A location where you can read a book, sit on the toilet, take a shower, listen to the birds, go in the hot-tub, bake bread, groan, nap, eat, walk around naked, squat, change your mind (no, I want to labour on the toilet!), and give directions to the midwife (the towels are on the shelf in the basement!), all within one hour of giving birth, and not have to worry about it at all. After the many stories I’ve heard of not being able to walk around, being told to lie down, and having to follow someone else’s rules during labour, I would opt for a free-birth rather than going in the hospital. The more stress, the more things to go wrong.

To me, it’s a no brainer. Home is the place to birth for me.

greenmylife's picture
Joined: 10/24/11
Posts: 355

"sarahsunshine" wrote:


bake bread,

To me, it’s a no brainer. Home is the place to birth for me.

Bake Bread? Really? We have definately had different labor experiences!!!!! lol

And "its a no brainer" because it is the only way you have done it!!!! I realize people feel strongly both ways. But I assure you my decision to go to a hospital has a level of "brain" involved. Smile

It is truely a personal choice. Both ways are right, thoughtful, intelligent decisions.

sarahsunshine's picture
Joined: 11/29/06
Posts: 1462

"greenmylife" wrote:

Bake Bread? Really? We have definately had different labor experiences!!!!! lol

And "its a no brainer" because it is the only way you have done it!!!! I realize people feel strongly both ways. But I assure you my decision to go to a hospital has a level of "brain" involved. Smile

It is truely a personal choice. Both ways are right, thoughtful, intelligent decisions.

Greenmylife - Yes, I did make bread when laboring with DS#1.

I did state that I had only birthed at home, for the very reason that you say – I have nothing physical to compare to, myself. I have had many conversations with my friends who have birthed in the hospital and at home, however, and from comparing our experiences, there is no way I would opt to go the hospital route.

That being said, I do have friends who opt for the hospital for very valid reasons of their own, and I have no problems with that, particularly since I know they have done their research.

My only concern is for those who maybe have not thought about the homebirth option, do not have a person with whom they can share their ideas in their personal lives, and do not know someone who has had a homebirth so that they can get objective information to compare the experience or get information on the safety of homebirth. That is why I believe this thread was posted.

Unfortunately, many of the people who opt for home-births are people who realize after their first birth that their preconceived ideas of birth were not realistic, and didn’t realize that home birth was an option.

RebeccaA'07's picture
Joined: 11/19/07
Posts: 1628

I think homebirths are pretty amazing - for everything that Audra & Sara have stated!

For us, we chose a hospital birth for my daughter. Really, it was that's because everybody else here does the same thing...so it was more of an uneducated decision. With that being said, I was glad that I was at the hospital due to the emergency c-section. I live at least 30-40 minutes away from the hospital so it wouldn't have been a good situation to be at home.

I am looking into a midwife or doula this time. I'm hoping for a VBAC and I would really like the best support system possible when attempting that. They are pretty inexpensive, insurance doesn't cover but for someone that will coach you the entire way $600 isn't terrible!

Best of luck in your decision.

Joined: 05/31/08
Posts: 1131

I'm considering a homebirth this time. Another option, by the way, is a birthing center with a midwife, or a hospital that has a midwife team. You don't necessarily have to have an OB if you deliver at a hospital, and midwives are more likely to know how to support your desire for a natural, unmedicated birth and much less likely to suggest anything if they know you don't want it. By the way, a book that helped me when I was trying to make similar decisions during my first pregnancy was "The Thinking Woman's Guide to a Better Birth." I highly recommend it, I plan to re-read during this pregnancy. I had DS at a hospital birthing center with a midwife. Personally, I don't think I'd ever choose an OB over a midwife, just because I am pretty committed to natural birth and that's what midwives are trained for. I also feel like I get more personal attention from the midwife.

kridda_88's picture
Joined: 01/28/08
Posts: 1798


I say follow what your heart tells you and not what everyone else tells you to do. As long as you make an educated decision along the way you will be doing what's right for you.

I've had two hospital births and this one is a planned home birth. My first birth experience was a disaster to say the least. I had NO control over my labor and birth and not because I didn't want it but because the hospital didn't "allow" it. I had my second, a natural birth with a birth plan, at the same hospital and still felt like I had no control over the birth. Not all hospitals are so willing to let mothers have THEIR birth experience. I had an IV put in against my requests and they put it in while I was in transition and in the middle of a contraction so I couldn't protest. There were several other things that happened that I specified in my BP that I did not want.

I ended up hemorrhaging and the cord was wrapped around my boys neck and chest and he was born fine and the hemorrhage was actually cause by the dr yanking my placenta out before it fully detached. Midwives, a good one, is trained to take care of all of these issues and if you are with in 20-30 minutes of a hospital you are just as safe as if you were at the hospital, that is IF you get a GOOD midwife. I have a certified licensed midwife who can do everything short of a c-section right at home. If I need an IV she can give it to me, oxygen she has it, Pit she can administer it. Yes sometimes the cord around the neck can be a serious issue but not as often as dr's make it out to be 1 in 4 baby's has the cord around the neck and in most of the cases it's NOT a medical emergency. A good midwife will transfer when something isn't quite right and will listen to the mom. She will also call ahead, this is where the just as safe part comes in, if you need serious attention. When she calls ahead and tells the hospital what is going on and to be prepared they will get OR ready and be waiting for you to arrive. When in the hospital it still takes them 20 + minutes to asses the situation and prep the OR. VERY RARELY do you have such an emergency that being right in the hospital will save mom or baby and even in those situations is it caught in time, even in the hospital because nurses and dr's aren't with you every minute of your labor and even birth.

jubileerose's picture
Joined: 06/12/09
Posts: 549

I gave birth to my daughter in a hospital, but was delivered by my midwife. It was a great experience, I just regret not speaking up for what I wanted. Just speak up and know your comfort zones, and you'll make the right decision.

Joined: 11/01/11
Posts: 143

Thank you everyone. I still want more info. I wanted to say that I live in a small town where everyone pretty much has a hospital birth. The midwife is 2 1/2 hours away, but will and has traveled here before for at least one birth I know of. I have to call her tomorrow and talk with her about making a first appointment with her. I don't believe from her website that I can give birth there. I am also unsure on whether I should be the one traveling while in labor or whether it would be better if she traveled.

The hospital here also does not have midwives at all. They are a small hospital that does not have a very nice maternity level.

So my choice is home birth or hospital birth. I am afraid that my voice won't be heard at the hospital. I do live about 5 minutes away from the hospital (small town).

I did not grow up here and I am from a much larger city. So I am glad that I found at least one other choice, even if I don't take it.

After I meet with her, I figured my husband and I can decide then (although he says it's ultimately up to me). So I am hoping that I like her.
I still don't know what questions I should be asking my obygn and the midwife.

Winky_the_HouseElf's picture
Joined: 02/10/02
Posts: 292

I have had one hospital birth and four home births. I'm having a hospital birth this time.

My first birth was medically-managed when there was no safety reason for it to be so. Interventions carry risks. The risks can be worthwhile if the benefits of the interventions are actually needed. When interventions are applied to a normal birth, they tend to cause complications rather than prevent them. Since most American hospitals by default use interventions for every birth, birth at those hospitals is not as safe as it could be. If a healthy woman carrying a healthy baby has a choice between a standard American hospital with a standard American OB or a home birth with a skilled midwife, a home birth with a skilled midwife is statistically the safer choice.

I feel that it is important to repeat the point that only healthy women with healthy babies should consider home birth. It is also imperative for the midwife to properly screen and transfer any mother/baby pair that develops a higher risk situation. I would absolutely avoid any midwife who has a reputation for taking on high risk cases because I would not trust her ability to transport in an emergency where time is a matter of life or death. If the only midwife in my area were like that, I would choose the most flexible OB I could find and make the best of the hospital.

When I had my four home births there were no hospitals in my area that leave birth alone unless there is a problem. Now there is one. If I can be left alone while also being in a place better equipped to handle emergencies, that is my safest option. I had my first prenatal today and my CNM is awesome. Smile

ETA: The Thinking Woman's Guide to a Better Birth by Henci Goer has excellent information on the benefits and risks of all of your options. It also has an appendix with questions to ask a caregiver and how to gauge his/her response.

Joined: 12/10/05
Posts: 1681

*lurker, but I am due in June Smile *

I had three natural hospital births (one induced, two spontaneous) and chose to have my fourth at home.

It was such a great experience and I'll definitely have this one at home too (assuming all goes well, of course).

Research has proven that homebirth is a perfectly safe option in low-risk pregnancies with comparable outcomes to low-risk hospital births.

So, while I really think all women should think about birthing at home as an option, that doesn't mean it is the right place for everyone. The key is LOW RISK, so need need a care provider with solid education and a proven track record. The same of OB's. If you would rather not have a c/s and your OBs c/s rate is upwards of 25 or 30% you need to question whether they are too interventionist.

I guess the best way to decide what to do personally is to read lots and think about what you would ideally like your birth to be like. What sorts of things are important to you? Then ask all the questions you need to get a feel for the OB and MW.

For the OB, I would ask about their c/s rates, how they share on-call, policies on things like fluids/food in labor, IVs, continuous fetal monitoring, what happens if you go overdue, etc.

For the MW, I would want to know about her experience and education, their c/s rates, their homebirth transfer rates, what would risk you out of a homebirth, do they have backup OBs, etc. And because of the distance from the mw, you'll want to go over details like where you'll deliver (will she come to you or will you go to home or stay in the other community?). If you're at home and there is a problem, does she have privileges in the nearby hospital? Could she accompany you as a "doula" if transfer was necessary?

Hopefully that helps!

CarolineJ's picture
Joined: 04/26/06
Posts: 133

I would never consider a homebirth, I have read and heard way too many horror stories where things have gone terribly wrong. I have had 2 lovely hospital deliveries. My private OB couldn't have been more attentive, or more caring. I consider him to be the best OB in our state, and nearly all Drs and Dr's wives choose him as their OB. My husband used to be his resident and insisted we have him.

Each to their own though, I think as long as people make informed choices, then it's a personal decision which needs to be respected.

Marite13's picture
Joined: 08/07/09
Posts: 3368

I think it really comes down to doing a lot of research and deciding where you're going to be most comfortable, because that will lead to your best birth. I had a natural hospital birth the first time, and I was so dead set on having a natural birth and not having anything pushed on me that I went in guns blazing, and probably spent too much energy fighting off interventions. I feel like my energy could have been better directed just in laboring. I also HATED being confined in the hospital for two days afterward and they would only let me leave against medical advice, and so we stayed. Made me want to pull my hair out. So I'm choosing a home birth this time. Because I know what MY views on birth are, and I think they will be better supported,*I* will be better supported by a professional midwife at home, than I was by nurses and my CNM (I really loved her) in the hospital.

And I just have to say, as far as scare tactics go... I have had no less than 5-6 friends on FB give birth in the last couple of months- all in hospitals and they have ALL ended up with emergency c-sections. Now, I don't know the specifics of each situation, but, 100% of 6 people ending up with c-sections is just not good odds in my book. That's enough to scare me away from a hospital any day! (And no, I'm NOT arguing against c-sections- I myself was a c-section, and if it hadn't happened, I would have been born with broken bones, so I am thankful for the possibility- but the rates for c-sections these days are WAY TOO HIGH and it is often because of too many interventions that they happen. That's all I'm saying.)

So it's good that you're looking for info here, but, this is such a touchy subject- you're much better off doing a lot of research on your own, and then figuring out what feels right to you, in your gut, in your heart- because this is a decision only you can find the right answer to, because it will only be the right answer for you. Good luck!

Joined: 05/31/08
Posts: 1131

My questions for an OB would be:
-I want a natural, unmedicated birth. Is that something you support?
-Does your hospital offer alternative pain relief options, such as whirlpool tubs, birthing bars or stools, etc.? (If not, that would be a clear indication to me that they aren't used to supporting mothers who choose to deliver without medication)
-What is your c-section rate?
-Is intermittent monitoring an option, or do you require constant monitoring? (a hospital that supports unmedicated birth will allow intermittent monitoring for mothers to be able to move around and pace around, etc)
-What are your policies as far as interventions like forceps, suctioning, epesiotomy, etc.?

For a midwife:
-How long have you been doing homebirths? How many babies delivered?
-How are you trained? Are you licensed? (You want a licensed midwife, of course).
-What is your hospital transfer rate?
-What methods do you use to support mothers in labor?

You will probably make a lot of your decision just based on who makes you feel more comfortable, who you click with best. You will do best in the place and with the person you feel safest, trust most and feel most connected with. Good luck!