How To Talk To Your Partner About Home Birth (plus: safety info!)

"I really want to have a home birth, but my partner isn't comfortable with it so we're planning a hospital birth instead" ← We hear this all the time.

At Bright Earth Doulas, we fundamentally believe in bodily autonomy. Bodily autonomy is the right to governance over one’s own body. This means giving people the power to make choices about their own bodies, without facing coercion, violence, or other consequences.

In birth, we believe people should be given education and support to make informed decisions, and those decisions should be respected. If someone wants to schedule a C-section without medical reason, they should be allowed to make that choice. If someone wants to induce labor at 39 weeks just because, they should be allowed to make that choice. And if someone wants to birth at home.... they should be allowed to make that choice too. Nobody should tell them they can't make a decision for themselves, including medical professionals and partners. If someone tells a pregnant person that they can't birth at home, they're disrespecting the bodily autonomy of the pregnant person.

Now... obviously the situation is more nuanced than that, right? A person desiring home birth might have medical complications that make midwives risk them out of care. Does this mean they can't plan a home birth? Of course not. It means that a midwife won't attend your birth, and you'll be birthing alone (also known as "free birth"). Some people might make that choice, while others feel it's risky and choose to birth in the hospital. Both are valid choices.

We can all look at the same data and make different decisions.

But let's go back to the original topic: you want to home birth, but your partner isn't on board.

How to talk to your partner about home birth

Step 1:

Bring up the conversation in a safe space, where you're not putting your partner on the spot.

Try saying: "Hey [Partner], I've been learning more about birth options, and I'm intrigued by home birth. Can we talk about it for a few minutes?"

If your partner responds positively, then start interviewing midwives (yay!). If they respond negatively, move on to step 2.

Step 2:

Get to the root of your partner's hesitation. Maybe they're worried you and/or baby will have a medical complication or die (this is a common partner fear, even for hospital birthers). Maybe they're worried about the mess in your house. Maybe they're worried about pets or older children being present.

Pinpoint the issue, validate their feelings, and then discuss solutions that resonate with your partner's personality type.

Try saying: "I'm hearing you say that you're worried I'll die. That's valid, and I'd be worried about you too if the roles were reversed! Can we learn more about the data surrounding home birth safety together?"

If your partner says "yes", scroll down in this blog post for safety information to share with them. If they say "no", go back a step and continue to ask about their hesitations. While this is their partner and baby, this is your body and they owe you the respect of having a conversation about your wishes.

Step 3:

Interview home birth midwifes WITH your partner.

Note: if you're currently seeing an OB/GYN, or even a hospital-based midwife, they're not the best provider to ask these questions. We always recommend talking to the medical professional who specializes in the birth you're planning. In this case, talk to a home birth midwife if you're exploring home birth.

Sample questions based on the examples we've been discussing so far in this blog post:

  • What is your transfer plan if baby or birther need to go to the hospital? Can you tell me about the last time you had to implement that plan in an emergency?

  • What life-saving tools (oxygen, meds, etc) do you bring with to our birth?

  • How do you prevent messes from bodily fluids in our home, and what does cleanup usually look like?

  • Do any of your clients have pets or older children at their births? What tips or requirements do you have for making it a positive experience for everyone?

We recommend interviewing 2-3 home birth midwives. Find a list of Minnesota birth places (home, birth center, and hospital): here or check out the Minnesota Homebirth Community on Facebook.

Step 4:

Do the work to prepare yourself for a home birth AND what would happen if plans change. Take a childbirth ed class (we have great hybrid options here), and hire a doula (book a consult with us here). Your partner should attend class, and attend prenatal meetings with your doula.

No matter what kind of birth you're planning, if you don't know your options you don't have any. Education and support are key to stack the deck in your favor for the birth of your dreams.

Great, we're talking, but... is home birth safe??

This is a meaty topic.... Home birth gets a lot of flak in the medical industrial complex for being "unsafe" or "crazy". Despite that reputation, 1-2% of Americans plan to birth their babies out-of-hospital (in this article, we'll shorten this to OOH). This can mean one of three things:

  1. A planned home birth with a midwife present.

  2. A planned birth at a freestanding birth center (read more about these facilities here: Hospital Birth Centers ≠ Freestanding Birth Centers)

  3. A planned home birth with no medical providers present (also known as "free birth")

NOTE: The safety information in this blog post is only referring to #1 and #2 - births where a midwife is present. If you're interested in learning more about free birth (#3), I'd recommend checking out Birth Uprising or The Free Birth Society.

What does the data say?

High quality evidence around home birth is limited, because there haven't been adequate randomized controlled trials. However, there have been publications based on observational studies of OOH birth. These studies have found significant reductions in interventions.

Per ACOG (the governing body over OB/GYNs), home births are associated with:

  • Lower rates of induction and augmentation

  • Lower rates of pain meds

  • Lower rates of forceps, vacuum, and C-sections

  • Fewer vaginal tears

  • Less maternal infectious morbidity

It's important to note that home birthers are more likely to be carrying low risk pregnancies. But these numbers stand even when we compare home birth to low-risk hospital birthers. (P.S. - only 6-8% of pregnancies are high risk, yet 98%+ of people are birthing in hospitals. This means the vast majority of hospital births are actually low risk)

What about death?

Overall, we see lower rates of maternal mortality in OOH births, and steady rates of infant mortality.

Maternal: This US article published in the Journal of Midwifery & Women's Health in 2014, and this Australian meta-analysis from 2018 are two of the most widely cited sources of lower rates of maternal mortality.

Infant: This study done in Washington in 2021 showed an infant mortality rate of 0.57 out of 1,000 births which is significantly lower than the national average of 5.4 out of 1,000 (source: CDC). But it's important to note that people birthing OOH are carrying low risk pregnancies. The leading cause of infant death is low birth weight (premature babies) and most birth centers and home birth midwives would transfer you to the hospital if you went into labor before 36 weeks.

Bonus articles: SOGC and Canada Embrace Home Birth - Why is the USA So Far Behind? It's not just Canada - we also see OOH birth embraced in European countries (like The Netherlands with a 30% home birth rate) who have significantly maternal mortality and infant death rates than we do in the US.

Conclusion: is home birth safe?

We can all look at the same data and make different decisions. You might look at one study and decide that home birth is safe for you, while your friend looks at the same study and decides that home birth isn't safe for them.

The safety of home birth is relative.

Your job is to decide what's right for your body, your baby, and your family.

Everyone else's job is to support your decisions and respect your bodily autonomy.

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