The Benefits of Giving Birth at Home

Chazal say that childbirth is one of three keys that Hashem retains and does not give control of to an intermediary. Childbirth is an amazing, primal process over which we have little control. Science still doesn’t completely understand many of the hormonal mechanisms of labor. The fact that a woman gets pregnant, carries her baby to full term, gives birth safely to a healthy baby, and experiences an uncomplicated postpartum period can only be considered a miracle.

The first mitzva in the Torah is pru u’rvu. Having children is crucial to the survival of our nation. This is so important to Hashem that He Himself is one of the partners in the creation of a child, along with that child’s mother and father. Hashem has a huge vested interest in women bearing children safely so that our people can continue to thrive.

As a nurse-midwife, I am trained that birth is a natural, healthy process until proven otherwise. The critical part of my role in guiding a woman through pregnancy and birth is ensuring she is taking care of herself to lead to a healthy outcome. We spend a lot of time discussing diet and healthy habits in pregnancy and postpartum to decrease the risks of developing illnesses like pre-eclampsia and gestational diabetes.

Midwives also put a strong emphasis on intuition, both the midwife’s and the mother’s. This intuition might also be known as bina yeseira. There is an innate sense that a mother has during birth; diving deeply into herself and shutting out the rest of the world, she is in a G-dly place. A cornerstone of midwifery is trusting the process of birth while watching carefully for warning signs. If any warning signs or intuitive concerns arise that birth is not proceeding safely, we try to figure out why, attempt to reroute, or consider transfer to a hospital for intervention.

When animals give birth in the wild, they find a safe place to ensure they will not be disturbed. If they sense danger and have to run, their labor will stop until they are safe again. Humans are not much different. Often, a woman can be laboring at home, but upon transfer to a hospital, her labor will slow down. The transition period and entry to an unfamiliar environment can affect the progress of her labor. Meeting new people, filling out paperwork, going through admission proceedings can all affect how safe she feels and, therefore, her labor.

Many people ask me what we do about pain relief at home. Truthfully, the number of women who transfer to the hospital solely for pain relief is very small. Maternal exhaustion is the number-one reason for transfer from a planned homebirth to the hospital. When a woman can enclose herself in the safe environment of her home – her own bed, bathroom, shower, trusted people – she has a much higher tolerance for the pains of labor. The main coping mechanisms we provide to help a woman through labor are encouraging affirmations – that her body was made to birth this baby, that she is strong and capable – as well as physical support and hydrotherapy, such as showers or birth tubs.

A critical part of the training of a midwife is to ensure the safety of birth at home. We carry an arsenal of supplies to births just in case they are needed. We bring the birth center to you! These supplies include oxygen, IV fluids, antibiotics, the same medications for hemorrhage that they have in a hospital, and resuscitation equipment. We bring two trained providers to every birth so we have two sets of eyes, two brains, and two sets of hands to keep an eye on the birthing mother, to look for warning signs, and to intervene swiftly as needed. We are all trained in CPR and neonatal resuscitation.

A hallmark of medicine is “do no harm.” A hallmark of midwifery is to sit on your hands. Labor is a natural process that usually goes seamlessly if not tampered with. We are not inducing labor or introducing interventions, so the risk of complications is low. The main risks to the baby and mother in a hospital setting are due to interventions and medications such as pitocin which are used to induce labor. We are at a birth to watch it unfold and support or intervene as necessary, which is very uncommon. Of planned homebirths, 11% transfer to the hospital and only 0-5.4% are emergencies.[1]

Common causes for transfer are failure for labor to progress (5.1-9.8%), fetal distress (1-3.6%), postpartum hemorrhage (0-0.2%), respiratory problems in the infant (0.3-1.4%).[2]  Even these complications are rarely emergencies if caught early enough.

The postpartum period is one that is sorely neglected in American society. We see a high rate of postpartum depression as women are left to navigate this tenuous period with little support. In my practice we stress the importance of resting for two weeks after birth, something most frum women think would never be attainable. In the hospital setting, the few days after birth are rarely ones filled with rest and healing. In the homebirth setting, we want you to stay in bed to rest, heal, and nurse your baby. We help you plan for that while pregnant to figure out how you can prepare for meals, childcare, carpool, grocery shopping, etc. With the right preparation, you can pretend you’re on vacation and take this sorely needed time to heal and be in a better place physically and emotionally. We do home visits twice during the first week postpartum to ensure that mother and baby are healing and thriving. There’s a lot that happens in those first six weeks, especially for first-time mothers, and we want it to be a successful transition.