Home Births: 5 Things Nobody Tells You

Photo: CorbisThe American Academy of Pediatrics has policy statements on pretty much anything you can think of—the role of recess in school, the timing of umbilical cord clamping, gay and lesbians as parents, you name it. But one topic it's avoided is home births, until today, when it (sort of) took an official position.

The Academy said that, while it believes “the safest setting for a child’s birth is a hospital or birthing center,” it “recognizes that women and their families may desire a home birth for a variety of reasons.” It further notes that parents should be advised to work with midwives certified by the American Midwifery Certification Board, and that “All medical equipment, and the telephone, should be tested before the delivery, and the weather should be monitored.”

Or, as the Daily Beast succinctly put it, the AAP basically said, “Ugh, fine.”

When I gave birth to my daughter at home in October 2008 (for a variety of reasons I won’t go into here because I’m just not always up for that discussion anymore) it was—and forgive me for being revolting—the most intense, incredible, beautiful, loving, magical day of my life. But hey, that’s just me. So, in honor of the AAP’s new “position,” I offer up a handful of surprising nuggets for anyone who’s curious, or who might be considering a home birth of her own:

A home birth can feel like a totally normal social gathering—a party, even. When I gave birth to my daughter at home, I had three people there to support me: my partner, our close friend (who took photos of the event), and our midwife, Miriam. In between searing labor pains, to my surprise, I was able to spend significant stretches of time doing totally normal things (even as I was sitting naked in a birthing pool in the middle of the living room the whole time). We discussed politics and the upcoming presidential election. We talked about the boy and girl baby names we had at the ready, and why. We listened to some of the hysterical birthing tales Miriam had up her sleeve. And we snacked (well, I did, at least), on nibbles from nuts to watermelon chunks. After the birth, we all hung out and snuggled (without Miriam, of course) and ate big bowls of pasta before falling asleep.

It can also feel like an acid trip. For all the normalcy—which kicked off with a stroll through a neighborhood park at the start of labor—there is a hyper-surreal quality to the whole situation that I can only compare to college-age altered states. You get used to a scene and you don’t want to leave it (like I got into the shower when my labor pains started getting fierce, and I didn’t get out for what might have been 45 minutes; it just felt so safe in there!). You leave one scene for another and return to find it looking really weird (like how I left my living room for the walk in the park and came back to find it oddly cozy but abandoned and in disarray). And your senses are crazily heightened: when my friend brought me an ice pop after I had requested one, the cold was so searing it was unbearable. “No! Too cold!” I yelled, and he took it away. Lights were unthinkable, so, as the sun began to melt away at dusk, we just lit candles and turned on a very low-wattage lamp. Luckily, at home, you can control it all.

You don’t need to live in a big house in order to have a home birth. I had fantasized about a home birth years before getting pregnant, but I live in a tiny New York City apartment, so I thought that dream was out (my fantasy had included an airy, sunny country home, with sheer curtains billowing in the late-afternoon breeze, and no one around for miles to hear me scream). But then I saw “The Business of Being Born,” the Ricki Lake documentary about urban women having babies at home, in tiny apartments, and I realized it didn’t matter. (How big is a hospital room, anyway?) When I wanted to move around, I just walked to the park. Eventually, I didn’t want to move at all, so I stayed put in the rented purple inflatable birthing tub, which fit perfectly between my couch and my bed, leaving plenty of space in the room for my guests, as well.

You don’t have to worry about cleaning up after the birth. “Ooh, but it will be so messy!” people say. Sure, birth is messy, as it should be. But do you have a partner who loves you? At least one friend you can count on? Then you’re set. After my water birth, my midwife helped me shuffle into the bathroom to take a shower and then I got into bed, where I held my tiny daughter, still largely covered in her waxy white vernix, close to me. Before I knew what had happened, the birthing pool was drained and deflated and gone. Poof! What are friends and lovers for, anyway?

Your health insurance may actually cover the cost in full. Perhaps the biggest shocker for me was this: that my insurer at the time, Meritain Health, a division of Aetna, covered the entire home birth, which cost around $7,000 (but might have been closer to half the price had I not lived in New York City). I’d girded myself for some sort of fight, with me defending my choice against the insurer, who would tell me that I was a fool and a hippie, and that I’d have to fork it over. Instead, I got a simple response: covered in full—which made fiscal sense for them, in fact, considering that the average national cost of a hospital birth these days is at least $10,000 (and easily twice that in NYC), according to the U.S. Department of Health and Human Services.