Many women who choose to give birth at home do so because they want more personal control and privacy, and are more comfortable in their own familiar surroundings. However, home birth requires a great deal of planning and preparation, including finding a midwife, working with your insurance to potentially pay some or all of the expenses, assembling a water birth pool and preparing mentally (and physically) for the birth itself.
When you give birth in the hospital, your birthing experience will be pre-arranged for you by the hospital employees and bureaucrats. Your birthing process will be managed by doctors and controlled by the hospital policies. By contrast, when you choose to have your baby at home, you will have more control, but it will also be your full responsibility to prepare and plan every little detail. You will have the opportunity to create your own birthing experience, so make it a good one by preparing properly!
My husband Kon and I had all four of our babies at home with a midwife. None of our friends and relatives had any home birth experience to share with us, so we didn’t know what to expect. After four home births, we have gotten the hang of it. You can read more about our path to choosing home birth here. Based on our experience, here are some suggestions about how to prepare for a home birth and make it as smooth and easy as possible.
*Top image: Our condo where we used to live and where we had all our home births.
Save Up Some Money
You will need to purchase some birth supplies, such as waterproof (Chux) underpads, waterproof mattress cover, oils. Your midwife may give you a list of items to purchase. If you are planning a water birth, you will need to buy or rent a birthing pool (if you rent, you will also need to buy a disposable liner), as well as pool-related supplies, such as a water hose and faucet adapter.
When it comes to your health insurance, the amount of coverage and what exactly is covered under your policy varies greatly state by state, and depends on whether you have an HMO or a PPO policy. Homebirth midwives are often considered out-of-network providers for both HMO and PPO. Insurance may cover only prenatal visits but not the midwife’s birth fee, or your plan may not cover any homebirth expenses at all. Your midwife may be able to file on your behalf, but you are ultimately responsible for working with your insurance and paying all uncovered expenses, so be prepared to pay some or all costs out of pocket.
With our first home birth, we sent a letter to the insurance company (PPO) and managed to get most of our expenses covered. With our subsequent home births, however, we ended up paying all expenses out of pocket.
Find a Midwife
During your most vulnerable and painful moments, when you experience fear and uncertainty, you want to have the right person by your side. A midwife is not just another service provider. She is going to be your mentor, partner, supporter, caregiver for you and your baby, and, in some cases, a long-term friend. A midwife will play an essential role in your pregnancy and birthing experience, so you will need to do a great deal of research to find the right midwife who will attend your home birth.
Search online for midwife recommendations from other moms, and make sure to personally visit and interview several midwives. Ask your midwife about her philosophy – for example, her position on prenatal testing or interventions during labor – and pick the midwife whose philosophy aligns with yours. There are many websites that provide interview questions for a homebirth midwife (for example this one), including questions about her education and experience, her philosophy, her emergency backup plan, and the equipment and supplies she carries. It’s also important to ask how many of her clients are due around the same time as you. You want to make sure that your midwife is not too busy to attend your birth.
We accidentally stumbled upon a book with the title “Pushed” before we were planning a baby. The book really changed our perception of pregnancy and birth. We decided to avoid the hospital and started looking for a more natural birth experience. Initially, we didn’t consider home birth and wanted to have our baby at a birthing center. However, I was very disappointed after my first prenatal visit. The midwives at the center had essentially the same philosophy about birth as hospital doctors, which was not the attitude I was looking for. It was then that we opted for home birth and started looking for a homebirth midwife. After several interviews, we ended up with the midwife who eventually delivered all our four babies.
Take Advantage of the Time With Your Midwife
If you pick the right midwife, you will discover that she can be an invaluable asset to your life as an expectant mom and your future life as a parent. Many homebirth midwives are very knowledgeable and experienced. Your midwife can give you great advice not only about pregnancy and birth, but also about lifestyle and nutrition, breastfeeding, parenting and caring for babies, and raising small children. I truly enjoyed prenatal visits with my midwife, when I could ask advice and get things off my chest. It was so helpful, educational, and therapeutic.
Once your pregnancy is over, you will be left to your own devices and there may be no other woman who will be always there for you to offer expert knowledge, friendly support, and sometimes a shoulder to cry on. While your midwife is with you, use her as an experienced friend and mentor and take as much advice as possible. Cherish the time with your midwife, because it will be over soon.
We were fortunate to receive a lot of quality time and help from our midwife. Her friendship and advice made a huge difference in our lives as parents. With her guidance, we discovered attachment parenting, such as co-sleeping with the baby, that practically saved us from sleepless nights, and babywearing, that helped me continue working while keeping the baby quiet and asleep. Our midwife’s presence in our lives made our home births and parenting much easier and much more enjoyable.
Clear Your Schedule
Caring for the newborn baby will take up most of your time for many months to come. So if you are planning any house projects, car repairs, major shopping, or any other pressing tasks, do it right now, while you still have time.
Also make sure that you have enough food, supplies, baby and personal items, clean clothing, gas in the car, and anything else you need for the first week after your baby is born, so you and your husband can focus on your recovery and caring for the baby.
These unrushed, slow, cuddly and happy days right after home birth are precious. Enjoy that time while it lasts, get as much rest as possible, and prepare enough in advance to avoid emergency shopping and other distractions.
Get Enough Sleep
Even with co-sleeping and breastfeeding, your quality of sleep will be greatly diminished, so it’s important to get enough sleep before you have your baby. When I was expecting my second and third babies, I developed a bad habit of working until late at night, so with my second birth which happened at night, I barely got any sleep. It was a big mistake.
Labor can be long and exhausting, so you want to get adequate rest and energy to get yourself through it. In your last month of pregnancy – when any night can be the night when you deliver your baby – get as much sleep as possible and don’t stay up late. You will miss your restful nights later!
Prepare Your Husband
You will probably want your husband to be present at your home birth and to help out. Some men like to be involved, and some like to stay out because they don’t feel comfortable witnessing a birth. Some husbands would like to help but don’t know what to do, or are shy in the midwife’s presence. Let your husband know that his help and involvement is much needed and appreciated. Your midwife may be able to guide your husband through his duties and explain to him what to do and when.
My husband Kon’s help and support was invaluable to me during all my births. He helped with everything – from planning to setting up the birthing pool to supporting me during labor to cooking meals. Our home births were truly shared experiences for us both.
Prepare Your Kids
If you already have kids, you will need to prepare them for your upcoming home birth. Some families send the kids away, some keep their kids present at home. It’s up to you to decide whether it’s appropriate for your kids to witness your home birth. In any case, you may want to talk to them or read them stories about home birth and get them involved in some of your preparations.
Because we homeschooled, our kids were around all the time and got plenty of chances to participate in preparations for the births of their siblings. They helped set up the birthing pool and went along with me to my prenatal appointments, where they played with their toys, looked over baby picture books that my midwife showed them, and even got to measure my baby and listen to the baby’s heartbeat.
Our kids also stayed with us at home during the births. We had our second baby at night, so our oldest daughter, a toddler back then, slept through the entire birth (to my great relief) and woke up to meet her brother only when she heard the baby’s first cries. Our third and fourth home births took place in the daytime, so the kids were at home during my early labor, and then Kon took them for a long walk so they were away during the actual birth and returned home right after the baby was born. By taking the kids outside, Kon helped me and my midwife focus on labor without distractions and noise.
Make Your Guest List
One of the benefits of home birth is privacy. In the hospital, it’s not up to you who is in the delivery room and how many people watch you give birth. At home, you get to choose who’s invited. I wanted as few people as possible, and I only wanted to invite those who were closest to me and who had a very good reason to be there. All our births happened with just our midwife, Kon and I in the room.
Keep Everyone Else Out
Once you decide who should attend your home birth, you will probably want to protect your privacy to ensure that your birth is as calm and free of distractions as possible. Family and friends who are not supposed to be present at your birth should stay away and not distract you with unnecessary phone calls and unexpected visits during your home birth. We kept my due dates a secret (not that due dates are accurate, anyway), because I didn’t want to feel the pressure to meet any expectations. Each time my labor started, we did not notify anyone except our midwife, because I wanted to feel as relaxed as possible, and I wanted Kon to be focused on me, rather than on answering anxious questions and calls. There is certainly time for visitors after the baby is born, but the birth itself is a personal, intimate experience and a time when the family’s privacy should be respected and protected.
Prepare your homebirth supplies in advance. Your midwife will give you a list of items to purchase and gather around the house, such as Chux underpads, mattress cover, towels of various sizes, baby hat, blanket and lots of diapers, and other personal care items for you and the baby.
You may need to get additional supplies, depending on your preferences. For example, a stability (bounce) ball can be used as a comfort tool during labor. If you prefer a water birth, you will need to prepare all the parts well in advance: purchase or rent the pool, get the disposable liner, hose, faucet adapter and water heater if desired.
I used a portable birth pool for all my births, because I found that warm water was soothing and helped reduce pain. We used small pools that could fit into our apartment living room, and pumped warm water from the kitchen faucet into the pool, using a garden hose. For our first two births, we rented a Spa-N-A-Box pool from our midwife. For our last two births, we purchased our own inflatable La Bassine birth pool which was much more comfortable and easier to set up (that brand is now discontinued, so here is an alternative product). If you plan more than one births with the same pool, you will need to change the disposable pool liner for each birth to keep the pool sanitary.
If you buy or rent a birth pool, designate a test day at least a week prior to your expected due date to practice setting up your pool, filling it with water, checking for any leaks, and draining your pool. During your birth, have your birth attendants set up the pool when your labor starts, so that you can get in when you need to.
Prepare Lots of Drinking Water
I like to think of labor as a workout. Just like an athlete who needs to stay hydrated during a workout, you should drink plenty of water during your labor. Drinking water keeps you hydrated and energized and even makes you feel relaxed by reducing the stress hormones.
Some women opt for food, but personally, I never wanted to eat anything during labor. However, water was a must for me. Holding on to a bottle of water and sipping between contractions felt very calming. It reminded me of exercising, so I imagined that my labor was nothing more than just another workout. It made labor feel easier.
Get the Camera Ready
When my midwife first suggested that she took photos of our home birth, I thought she was joking. I didn’t think that giving birth was particularly photogenic. But she proceeded taking photos which later became our cherished memories.
Get your camera ready and have someone photograph your home birth. No one, except for you and your husband, needs to see these photos. But these photos will be your cherished memories and unique treasures.
Feed and Care for Your Midwives
Prepare some food and water, pillows and blankets for the midwife (or midwives) who will attend your home birth. The midwife’s job is hard. She will have to leave the comfort of her home and come to you whenever your birth starts – even in the middle of the night – and will stay with you as long as necessary. Your midwife must stay alert and have the energy to support you through the birth. Help her by taking care of her and ensuring that she is fed and gets some rest when possible.
Have an Emergency Backup Plan
Pick the closest hospital where you would like to be transferred in case an emergency arises during or after your home birth. Discuss an emergency plan with your midwife and ask her what situations require a transfer to the hospital and how she manages these situations. Find out the average EMS response time in your area, so you know how soon to expect an ambulance – should you need one – and make emergency plans accordingly.
Prior to home birth, fill up your gas tank and keep all your phones fully charged. You will most likely want your husband by your side during an emergency, so if you already have children, designate a friend or a relative who can come at any time, on a very short notice, and watch the kids for as long as needed while you are in the hospital.
Exercising was the best thing I did for all my pregnancies and births. Prior to my first pregnancy, I took some personal training sessions, which gave me enough confidence to continue working out on my own at home and in the gym. During my first pregnancy, I had lots of free time which I spent exercising. In my subsequent pregnancies, I was busier with work and kids, so I didn’t have much time to work out, but still did my best to exercise at least occasionally and stay in shape.
There are many well-known benefits of exercising during pregnancy. Workout helps the body release chemicals that improve your mood. Exercise strengthens your body and helps you develop endurance that will be necessary during labor. When you work out, you learn a lot of useful skills which will help you in labor: how to control your breathing, how to control and listen to your body, and how to stay loose and relaxed under physical pressure. A body that’s trained and strengthened by regular exercise is much better prepared for handling the challenge of labor and giving birth.
You will need physical strength to carry your baby after giving birth. For example, having strong arms and back makes babywearing much easier.
Simply put, physical exercise is very healthy and beneficial for you and the baby. I believe that any expectant mom should exercise to the best of her ability and do so as consistently as possible throughout pregnancy. If you can’t go to the gym, you should schedule regular times to exercise at home and even exercise with your older kids.
Of course, pregnancy is not the time to go hard on yourself and complete fitness challenges. You should know your abilities and limits. Exercise during pregnancy should be light or moderate at most. Don’t do any strenuous workouts, especially in the third trimester.
I mostly did light to moderate weight exercises throughout my pregnancies. I did both dumbbell workouts and body weight exercises such as push ups and tricep dips. Depending on the muscle group being exercised, I suggest using light to moderate weights and trying do as many repetitions as possible to give your muscles a good workout. I used 5-lb dumbbells in each hand for smaller muscles such as triceps, biceps, and shoulders, and 8lb dumbbells in each hand for larger muscles such as back and legs (for exercises such deadlifts or squatting with weights). Awesome Body Pump videos were the best for my home workouts during pregnancy.
I do not recommend bouncy cardio workouts such as jogging or jumping during pregnancy. The only cardio exercise I did was on an elliptical when I could go to the gym. I found an elliptical to be a great cardio workout option for a pregnant woman, because of its low impact and smooth motion. In addition to weights and some cardio, I did slow and gentle stretching on a regular basis.
Get Ready to be Patient
Natural labor can last many hours. Some women have labors that last for a few days, on and off. You should prepare yourself to be patient during labor and learn to wait, rather than panic and try to rush things. Of course, your midwife should monitor you during labor, but if everything seems normal and healthy, be prepared to patiently wait and let your labor run its course. Similarly, make sure that everyone who will be present at your birth knows to be patient and is prepared give you as much time as you need without rushing you.
I always liked to be in control of everything. With my births, I learned that sometimes you just need to let go and surrender, and let your body and the natural flow of labor do its thing. You are not going to be consciously in control, so you need to learn to be patient with your body and let it work through contractions just the way your body is supposed to do. If you are healthy and labor is normal, don’t panic, don’t ask to be checked all the time, and don’t try to rush things. During my labor, my midwife helped me feel unrushed and invited me to take all the time I needed. Knowing that my birth attendants had full patience and trust in me, and that there was no pressure to perform, I could better relax and focus on my labor.
Leave Google Alone
If you are healthy and having a normal pregnancy with no obvious risk factors, don’t try to make things up to scare yourself. When I was pregnant, I kept Googling for horror stories about birth complications that seemingly came out of nowhere, such as amniotic fluid embolism. I kept imagining these complications happening during my birth, and getting worried and scared.
Yes, there is always some risk involved in any birth, at home or in the hospital. Yes, unexpected complications may happen even to healthy people. But these things are rare. These homebirth horror stories I was reading were pretty rare occurrences, which is why they made it to the blogs and news. There are many more successful homebirth stories that you can read for inspiration. And – let’s not forget – complications happen in the hospital, too.
So, unless you have apparent risk factors, don’t make up problems and scare yourself for no reason. Rather than worrying about rare complications, try to eliminate more common risks.
Together with your midwife, watch out for warning signs and symptoms. Try to eliminate risk factors, such as smoking or obesity, that lead to common pregnancy complications. Stick to a healthy lifestyle. Have an emergency backup plan. Last but not least, keep your house clean to minimize the risk of infection.
Enjoy Your Pre-Baby Time
If you are expecting your first baby, enjoy the last months of your carefree life! You will soon become a parent, and your life will change forever. This is a good thing, but before that happens, enjoy the life you are having right now. Take a vacation. Do something you have always wanted to do, but never had a chance. Catch up on reading. Get plenty of quiet, uninterrupted time. Even if you already have kids, be sure to carve out some time for yourself.
Enjoy the quiet, carefree time while it lasts, because everything will change very soon, and you won’t get much time for yourself for a long while.
Once you have prepared as much as you can, relax and focus on the task ahead. Face up to the challenge, which will hopefully become a happy and unforgettable experience for you. Good luck, and have an easy and successful home birth!