Bringing Out Baby ... at Home

May 28, 2001 -- "Having my baby at home was beautiful, inspiring, awesome!" says Jo Anne Lindberg. "I had complete freedom of movement and absolute choice in everything I wanted to do."

Lindberg actually went to the movies during early labor, and then safely delivered a 9 1/2 pound son at home. "It was a lot of work, but no pain," she says.

Being able to relax in a familiar, comfortable environment surrounded by those you love decreases anxiety, which in turn decreases pain and lets your body do its job, she explains.

As president and founder of Birthlink in Chicago, a free referral service for expectant parents considering home birth, Lindberg often refers women to Penny Shelton, MD, MPH, a general practitioner with HomeFirst, a group that has safely delivered more than 15,000 babies at home.

"Giving birth at home supports the normal physiology better," Shelton tells WebMD. "We're treating it as a normal part of life instead of a medical condition." Studies have shown that women who feel anxious or stressed release more adrenaline, a hormone that interferes with labor, she explains.

Not for Everyone

But home birth is not for everyone. Shelton says that women with uncontrolled diabetes, chronic high blood pressure, or a condition called toxemia (also known as preeclampsia) should deliver in the hospital. If labor begins before 37 weeks in a woman who's already given birth, or before 38 weeks in a first-time mom, it's safer to go to the hospital.

And if the father does not fully support the mother's decision to give birth at home, Shelton also recommends against it.

In the absence of these complications, home birth is typically safe, provided there are enough trained hands on board. Shelton prefers to work with a team that includes a midwife and nurse, but acknowledges that some well-trained certified midwives are capable of delivering without the assistance of a physician.

"Most physicians and nurse midwives are unwilling to attend home births," Martin A. Monto, PhD, chair of social and behavioral sciences at the University of Portland in Oregon, tells WebMD. He explains that most home births are attended by "direct entry" or "lay" midwives who learn through apprenticeship rather than through conventional medical training.

Their training may include skills not traditionally taught at medical or nursing school, such as gentle stretching of the tissues surrounding the birth canal to avoid having to surgically cut the tissue to allow the baby's head to pass through, a procedure called an episiotomy. Direct entry midwifery is illegal in some states, he says.

Home Birth Less 'Medical' for Most

"When comparing women with low-risk pregnancies, women who give birth at home are less likely to have episiotomies, C-sections, and all other forms of medical intervention than women giving birth in hospitals," Monto says.

Shelton carries emergency equipment, including oxygen for babies not breathing well, but seldom has to use it.

Alice Bailes has the same experience.

"I throw out my IV bags because they're expired more often than I use them," says Bailes, CMW, co-director of BirthCare and Women's Health, a service of certified nurse-midwives in Alexandria, Va. Her delivery team often includes an RN or practitioner certified in neonatal advanced life support.

To make labor more comfortable and efficient, Bailes recommends "low-tech" interventions like changing position or taking a shower. Being able to move around free of a fetal monitor, IV, and other restraints typically used in a hospital is also a major advantage, she explains, as is not being pressured to deliver within a specified timeframe.