The big difference between giving birth to your baby at home instead of in hospital is that at home you're in charge and everyone else supports you. The major drawback is that if anything does go seriously wrong, medical backup is not immediately to hand. Fortunately, the chances of this happening are very small because of the more relaxed environment.
What to expect from a home birth
In the early stages of your labour, you'll probably want to keep active. Use this time to make sure all is ready in your birthing room, gathering sheets and newspapers and preparing all the things you, your midwife, and the baby will need. Once labour is really established, you or your partner should phone the midwife if she isn't already on her way, as well as anyone else you want to be there.
Your midwife will be with you throughout labour and she'll monitor the baby every five minutes with a hand-held ear trumpet or sonicaid. She and your partner will encourage you and help you into the most comfortable positions; she can give some pain relief if you need it.
You may find it helpful to squat as the baby is being born. Your partner may “catch” the baby before putting him to your breast so your baby can breastfeed immediately. His cord will be clamped and cut once it has stopped pulsating and he will be quickly checked over (see Apgar score). The midwife will then help you deliver the placenta before giving your baby a more thorough check and weighing him in a spring scale. You'll be cleaned up and, if necessary, stitched. While this is happening your partner can be holding, cuddling, and looking after your new baby. Then you'll be ready to get to know your new family member.
The advantages of home birth
There are obvious advantages to having your baby at home: you'll feel secure in your own familiar surroundings and you can have as much privacy as you want. Your partner can play an important part in the birth and your other children can be there. You'll have the major say in your labour and it's easier to avoid routine medical intervention. You'll probably have the same midwife throughout and there's no danger of being separated from your baby or your partner afterwards. Bonding and breastfeeding usually happen spontaneously after a home birth.
The disadvantages of home birth
Most home births go without a hitch, but there can be problems. Your baby may get “stuck” during the delivery or have difficulty breathing at birth (although breathing difficulties in the newborn are often due to pain-killing drugs given to the mother - one risk that does not usually occur at home). You may retain some or all of the placenta or bleed heavily.
Not all of these problems mean that you have to be rushed off to hospital. Most breathing difficulties, for example, can usually be eased by clearing the airways, giving oxygen, and massage; midwives carry oxygen just in case. But if you have a retained placenta or start bleeding heavily, you and your baby will have to go to hospital and your midwife will go with you. A very few babies may be born too weak or disabled to fend for themselves. They will need the attention of a special care baby unit. If your baby is needy, you and he will have to travel to the nearest obstetrical unit.
Remember, too, that childbirth can be a very messy and noisy business, and a home birth does mean quite a bit of advance preparation to get the room ready and get the supplies you'll need (see Preparing for a Home Birth).
Get more on this subject…