We often have mamas who want to have a different birth experience than they had the first time around. This post is about homebirths, birth center births, midwives, and related topics, as pertaining to locations where a variety of options are available. If you live in an area without good hospital options, please make a post about monitoring and advocating so that we can help you most effectively.
ACOG states that a hospital is the safest place to birth, and as an evidence based group, we support those recommendations for our population. Find more information here. The NHS also says that, for women who are not low risk, the hospital is safest (see more info here).
May I have a homebirth while having or after having preeclampsia/gestational hypertension/eclampsia/HELLP?
Homebirths are for low risk women, according to ACOG and similar. If you have had GH, PE, E, or HELLP before, or have one of them now, you are no longer a low risk mama, and you should not be eligible for a homebirth, unfortunately. While most women will not have a hypertensive disorder again, we are at higher risk compared to women who have never had those complications, and we need to be monitored closely.
What about a birth center?
May I have a midwife?
I really wanted a waterbirth.
What if my midwife and I are very careful to keep a close eye on everything?
I understand that if things go sideways, saving lives is most important, but what if all is well, and baby and I are both stable and healthy? May I have low or no interventions, go without an epidural, have immediate skin to skin, and the other things I would like about a homebirth?
Should I have a doula?
But the hospital is full of COVID! I'd like to avoid that. Or, I had a really negative hospital experience and am considering a homebirth so that I can have a better experience.
I have experienced discrimination and/or obstetric violence, but I found a midwife who gets me, and I really don't want to go to the hospital with the OB who treated me poorly.
I had a home or birth center birth previously, and now it looks like I have to birth in the hospital, or I was planning a home or birth center birth and now need to change plans because of health circumstances for baby or me. I'm really sad and angry and scared.
I would like to share my own experience, so that you know you are not alone. When I was a low risk mother, I had several babies at a freestanding birth center and home, all with midwives, no complications. Then I needed to transfer, mid-pregnancy, to an MFM team because of a concerning ultrasound and then preeclampsia. I found the team to be very warm and caring, even as they were honest about their concerns for baby and me and even amidst all the high-tech monitoring and eventual crash c-section for fetal distress at 26 weeks. That all made me extremely high risk the next time around, not eligible for my midwife even if I'd wanted to, but I found that my MFM provided the same personalized care my midwives always had, with the added security of very close monitoring and readily available emergency measures. Since baby and I both remained stable, she and the hospital staff were very happy to work with us for a low intervention birth within ACOG guidelines, even encouraging a gently induced VBAC. We got our immediate skin to skin and all the things that were important to us, and truly, in the end, we did not miss our homebirth at all.
Bottom line: Talk with the hospital about their policies, but it really, really will be okay, wonderful, even. We are happy to help you with how to talk to your team about your concerns, questions, and desires, so please post below if we can help.