Home births vs. hospital births: What you need to know about both

Unless you’ve gone through it yourself, most people have preconceived notions about what it means to give birth.

A large population of women in Canada give birth at hospitals, but home births also make up a portion of deliveries in provinces like Ontario.

Global News

Nicole Bennett with Ryerson University’s midwifery education program in Toronto said it’s hard to pinpoint whether home births are getting more popular in the country, but research in Ontario has shown midwives are involved in 17 per cent of births in the province, and 20 per cent of those clients deliver out of hospitals.

“Midwives are taking care of more and more clients,” she told Global News. “Our client base is more diversified. Back when we started, during the re-emergence of midwifery care in the ’80s and ’90s, it grew out of the home birth movement.”

These days, she added, people from all walks of life are turning to midwives.

“There are certainly more births happening out of hospital,” she continued, adding that in a given year, this can mean 4,000 babies born at home in Canada. This also includes birth at birthing centres, which are limited to only a few provinces.

The biggest differences

Bennett said the biggest difference between the two methods of birth is access to medication. At hospitals, people have access to certain types of pain relief medication like epidurals, which are not offered by midwives at home. They also have access to nurses, OBGYNs and other hospital staff who could assist with the birth.

For some women, the idea of being in a hospital feels safer, she added. In such a setting, anyone who is anxious or worried about how their birth will go has access to a full medical team who can handle any complications, such as performing a C-section.

Birth is also messy, and some people may not be into the idea of giving birth in such a personal space as their own home.

But for others, it’s the opposite. Bennett said people who have home births often feel safer or more comfortable in their own homes. Some women also don’t have access to a hospital nearby and a home birth is more feasible.

“Some people worry about [hospital] intervention,” she continued.  “People have more control at home — who’s going to be there, control the environment… we are a guest at their place,” adding that home births don’t have to follow the protocols of a hospital.

One report from the International Journal of Women’s Health found that some women felt pressure to receive medication during hospital births or felt they weren’t being heard when discussing pain. Women who choose home births often don’t have these same pressures.

For others who choose home births, it can also be about recovery.

“If you have a baby [at home], we stay two to four hours after the birth and come back the next day… you don’t have to leave your home,” Bennett explained.

Safety concerns

Previous studies — including this one from McMaster University in 2015 — have shown the risk of adverse birth outcomes is low for both home and hospital births.

Dr. Jeffrey Ecker previously wrote on the Harvard Health Blog that there isn’t enough data to gauge how safe a home birth is but added there should be more research in planned home births versus unplanned home births. 

“Unplanned home births may include factors that make home birth look riskier than it may actually be (for example, birth due to unexpected emergencies or for women who have not had access to regular prenatal care),” he wrote.

“On the other hand, counting complicated deliveries that start at home but can’t be completed there as ‘hospital births’ might hide home birth risk.”

Both Ecker and Bennett note that home births are not for every excepting mother. For women who have a low-risk pregnancy, a planned home birth may not result in complications, but it’s recommended that women who fall under certain risk categories due to their family history, age, weight and so on speak with a doctor first.

“It is very individual,” Bennett said. “Most people [who] have normal, healthy pregnancies are candidates to deliver at home. If something happens and we need to transfer to a hospital, there is no urgency for it.”

A transfer can occur if there is a prolonged labour, if the mother wants medication or if there is another complication with the mother and the child.

Researchers in the McMaster study found that 75 per cent of women who planned a home birth were able to deliver at home, while 97 per cent of women who chose to go to hospital gave birth as planned.

At the end of the day, expecting mothers and their families should always speak with a health-care provider and, if they choose a home birth, make sure the midwife has proper credentials.

—With files from the Canadian Press

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