IS HOME BIRTH SAFE?
Ample evidence supports the safety of home birth for healthy, low risk pregnant and birthing people planning to give birth at home with skilled providers. Overwhelmingly, the evidence shows higher rates of vaginal birth, lower rates of medical interventions (cesarean section, episiotomy, vacuum or forceps delivery, induction or augmentation of labor, epidural use and other pain medication, assisted ventilation for the newborn and NICU admissions) and a lower incidence of several labor complications (parental infection, meconium staining of the amniotic fluid, fetal intolerance to labor, severe perineal tears). The data suggests that there is a small increase in adverse neonatal outcomes for planned home births vs hospital births for first time birthers, but the absolute numbers reported in both birth sites are still very low. For people who have already given birth, research shows no difference in the health outcome for the parent or baby. (ACNM Clinical Bulletin #61)
The risks of home birth are primarily due to not being able to immediately access advanced / emergency medical interventions for birthers or babies, as one would have access to if they gave birth in the hospital. Even though the evidence shows the safety of out-of-hospital birth, there are times when complications arise that go beyond the scope of a Certified Professional Midwife. Most of the time, if complications arise, they do so slowly, providing ample time to transfer to the hospital. CPMs are equipped with training and medical tools to assess, monitor and provide emergency care at home while initiating a transfer to a hospital. Please see Threshold Community Midwives’ “Plan for Consultation and Transfer of Care” Document for conditions that would necessitate a transfer-of-care to a higher level provider or medical facility. At your 36 week home visit the midwives discuss scenarios that would necessitate a transfer to the hospital during labor. In the event of a hospital transfer, the midwife will escort the client to the hospital and move into an advocacy role, as the hospital staff take over the role of primary medical provider.
While our goal as midwives is always a physically, emotionally, and mentally healthy and safe birth, we also acknowledge that birth is an intense and unpredictable experience, and a 100% guarantee of safety is not possible no matter the birth location.
who can have a home birth?
Home birth is safe for healthy, low-risk, pregnant people. There are some preexisting medical conditions that would rule someone out of having a home birth. We’d be happy to talk with you to see if you’re a candidate for home birth care. Contact us!
You can have a home birth no matter what your living situation! We have attended home births in single family homes, small apartments, tiny homes, in collective houses and beyond!
what supplies do i need for my home birth?
The midwives bring all of the medical supplies to your home birth and are included in the global fee for your care. There are some items that you need to provide (either purchased new or gathered from around your house / borrowed from others). We provide a list of supplies you need to gather. These are things like towels, baby blankets, wash clothes, cleaning supplies, hoses + attachments if you want a water birth, etc. Usually any supplies you need to purchase do not exceed $50.
CAN I STILL HAVE A HOME BIRTH if I previously had a cesarean birth?
Yes! Home Birth After Cesarean (HBAC), often called Vaginal Birth After Cesarean (VBAC), has the potential to be a triumphant and powerful healing experience! We are happy to provide care for families planning a HBAC. In the state of Vermont, pregnant people with a prior cesarean birth need to meet certain criteria to be considered low-risk and therefore appropriate for out-of-hospital birth. Please contact us to discuss these specifics.
Who attends your home birth?
Two midwives will always attend your home birth. The midwives, Emmy and Tessa, attend most births as a team. If one of them is off-call at the time of your birth, we will arrange to have another local CPM as our birth assistant. We do our best to plan this out ahead of time and will bring our CPM assistant to your 36 week home visit so you may have a chance to meet them prior to your birth. In the case of an emergency (illness, family emergency, or two births happening at once) you will not get a chance to meet the birth assistant in advance. We apologize for this inconvenience and appreciate your flexibility in these rare emergent situations.
what if I need to transfer to the hospital?
Most hospital transfers that occur are not due to emergencies. Many transfers occur for pain relief, exhaustion or the need for labor augmentation medications. In these instances, we discuss your options for preferred hospital, make a plan and drive to the hospital in a private vehicle (without the use of an ambulance). The primary midwife will accompany you to the hospital, moving into an advocacy role, as the hospital staff take over the role of primary medical providers.
In the event of an emergency, we will stabilize the parent and baby until an ambulance arrives at the home to escort the clients promptly to the nearest hospital. The midwife will accompany the family to the hospital, usually in a separate car. CPMs are equipped with emergency medical training including Cardiopulmonary Resuscitation (CPR), Neonatal Resuscitation Program (NRP), and carry emergency supplies such as IV fluids, oxygen, medications to control bleeding and suture supplies.
Can i have a WATER BIRTH?
Yes! Research supports that water birth is safe for both the parent and the baby. Many people find that laboring in the water greatly increases relaxation, increases comfort and relieves muscle tension and pain. People can choose whether they want to use the tub only to labor in as a comfort measure or in the moment you can decide to give birth in the water.
We rent birth tubs for folks to use for their birth. The cost is $__. We have families purchase a hose and a faucet adapter to use in their home to fill the tub with. We provide all the clean up associated with water birth.
How much does it cost to have a home birth?
*** add to this section once we figure it out
DO YOU TAKE HEALTH INSURANCE? MEDICAID?
We do not currently accept health insurance (private or Medicaid). Insurance companies require licensed midwives in VT to purchase Medical Malpractice Insurance. Currently, the medical malpractice insurance fees are expensive (and rates are continuing to increase!). Due to this, it is not financially viable for us as a practice at this time to purchase medical malpractice, and therefore cannot accept insurance reimbursement. We do work with insurance companies as out-of-network providers and can help you navigate getting your insurance company to reimburse you for our care.
We are passionate about making our care and services accessible to people of all income levels. We offer sliding scale options, discounts and payment plans to help folks in need. You can learn more on our Payment and Fees page. Please reach out to us with questions and concerns about your specific financial situation to discuss how we can make this work.