75. How to Overcome Common Fears About Home Birth Safety with Evidence-Based Midwifery

Have you ever wondered how evidence-based midwifery can help you feel confident in the safety of a home birth?

In this episode, we will cover:

• The most common fears about home birth safety and how to address them with personalized midwifery care.
• Why trusting the birth process can empower you to make confident choices for your family-centered midwifery journey.
• How a supportive birth provider ensures holistic birth support while prioritizing safety...
• … and a whole lot more!

If you’re ready to overcome your fears and embrace the safety and empowerment of home birth, then this episode is for you!

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👋 WHO AM I?

Welcome, friends! I am Beth, a certified nurse midwife, doula, and childbirth educator. My philosophy is rooted in autonomy, informed decision making, and positive mindset to help expecting parents plan for a beautiful, stress-free birth. I am here to provide value to YOU through tips and practical advice, either to guide you through pregnancy or to help you prepare for childbirth, postpartum and beyond. There’s no fluff here - only info that adds to your positive experience and saves you stress and uncertainty.

Transcript

Hello, and welcome to episode 75 of Your Birth Bestie podcast. Thank you so much for tuning in today! If you have been considering home birth but feel hesitant or held back by fears about the safety for you or your baby, this episode is definitely for you, and I'm so glad you're here getting more informed to be able to choose the best birth setting for you. Full transparency, I am a homebirth midwife, but I'm not here to convince you one way or the other, just here to give you some information that I think is helpful about this topic. I still do often support moms in hospital and birth center settings via co-care as a midwife or as a birth doula, because it is up to you to choose the best place for you to give birth.

So today, we’re diving deep into the most common concerns about home birth and how midwives ensure safety every step of the way. Whether you're worried about what happens if something goes wrong, questioning if home birth midwives are truly prepared, or feeling pressure to believe hospitals are the only safe option, I want to break down the evidence and share real stories that will help you feel more confident in your choices. Let’s get started!

Let’s start by talking about some of the most common fears I hear about home birth safety. These include:

“What if something goes wrong?”

“Home birth isn’t as safe as a hospital birth.”

“Midwives don’t have the training or the tools to handle emergencies in the home setting.”

“Hospitals are the only place where birth can be truly safe.”

These fears are 100% valid because birth is a significant event, but when we break them down and look at the facts, we can make informed, confident decisions rather than letting fear guide us. Overall, I don't think it makes sense to think of this conversation as being black and white to which setting is safest for every single woman, because you're an individual who has values and birth preferences and a unique personal and medical history, so you're birth isn't going to look the same as your sister or best friend. Safety and risk are all relative to your beliefs and values.

But we can talk about the data a little bit too. Planned home birth for low-risk pregnancies, attended by a trained midwife, is supported by research as a safe option.

Studies show that for healthy, low-risk pregnancies, home birth outcomes are comparable to hospital births in terms of safety.

Also, intervention rates are significantly lower in planned home births, reducing the risks associated with unnecessary medical procedures like induction or use of assistive devices for delivery.

One of my clients was initially skeptical about home birth because of the stereotypes of home birth midwives and about safety, and her husband wasn't on board at first either. There was a long conversation about the role of a homebirth midwife and the training involved and emergency skills. It also helps to learn more about what home birth midwives are able to carry in their birth bags to your home and what their scope is regarding management and treatment in the home. After a long conversation and talking about her personal situation, she felt confident that home birth was the best choice for her and was the most comfortable with the care home birth midwives could provide.

This common assumption that home birth is inherently unsafe without zooming out and looking at the bigger picture and weighing all the options and the pros and cons to all birth settings can cause a family to make decisions based on fear rather than trusting themselves. Like I mentioned before, there is a risk to everything, and it is up to you to decide for yourself what you're comfortable doing in your pregnancy and birth. Hospital birth isn't completely without risk either, and there are other components of being on a hospital unit that can lead to increased interventions and less satisfaction with your overall birth experience. 

The next piece to this is understanding how midwives assess and manage risk, because this is a huge part when talking about keeping home birth safe. A common misconception is that midwives take unnecessary risks by avoiding hospitals, but this couldn’t be further from the truth.

As midwives, we are trained to:
Identify risk factors early in pregnancy to holistically manage any concerns to then minimize any situations that would cause a client to risk-out. It's about prevention and early detection!
We are trained to continuously assess both mom and baby during labor and recognize when a transfer to a hospital is necessary and make those decisions swiftly. 
As a midwife, I am glad to have prompt access to advanced medical care in the hospital when it is needed. A transfer should never be thought of as a "failed homebirth" and your midwife shouldn't be afraid a transfer would reflect poorly on them, it is about access to care when it is truly necessary. Nobody planning a home birth wants their plans to change, but transferring when necessary is crucial to keeping mothers and babies safe, and I would never consider that to be a "failure".

Another fear is that midwives are not equipped to handle complications in the home. The truth is, home birth midwives bring a range of medical tools and skills to manage many situations, including:

Fetal monitoring equipment to track the baby’s heart rate.
IV fluids and medications to manage postpartum bleeding.
Oxygen and resuscitation equipment for mom or baby if needed.
Knowledge and skills to manage a difficult delivery.

Most of the time, birth works, but when there are complications, like in the case of increased bleeding for mom, there are protocols that midwives have to stop the bleeding, prevent further bleeding from occurring, and continue assessing and caring for her until she is stable and everyone is comfortable with the plan to stay home, or there is additional concern and the midwife recommends transfer for additional care at the hospital. In both cases, moms can have safe deliveries and stay home or transfer for additional care when appropriate.

It's important families know about this, because many people don't know that for example, many of the same medications used at the hospital to manage postpartum hemorrhage, home birth midwives carry and can administer too. But without education like this, unnecessary fear can overshadow, because bleeding is scary of course it is, but the truth about home birth can actually be reassuring many times.

The next common mistake that I hear all the time is viewing the hospital as the only "safe" option without considering the risks of routine interventions. It is easy to overlook the benefits of a low-intervention birth at home, if everyone you know has only had a hospital birth and all you hear about is how home birth is risky, they would rather be in the hospital where emergency intervention is available. But like we just talked about there are resources at home to be utilized if needed...

And while hospitals can be life-saving, there is absolutely a time a place, they also come with risks of their own including:

Higher rates of interventions like inductions, epidurals, and C-sections that can sometimes lead to complications or long-term issues for moms and babies.

Routine procedures can disrupt the natural birth process, leading to a longer or more difficult recovery. It is incredible how the body is designed to birth and how, when left to naturally labor, the hormones work with each other to help with pain management and labor progress and again, birth usually works when we are hands-off.

The last part I want to talk about is encouraging you to build confidence through education and open communication to overcoe any fears you might have when considering a home birth. The more you know about home birth, the more confident you’ll feel.

Ask your midwife or a potential midwife if you're in the planning stages about safety protocols and emergency plans.

Have honest conversations with your support team about your fears. Allow yourself to be vulnerable and ensure your values are communicated and respected.

And trust in your body’s ability to birth naturally with the right support. This seems simple, but it can actually be really challenging within the birth culture today. I would love to see this change and to encourage more moms to trust the process and feel informed with information to do this.

If you have any fears or concerns of safety due to discomfort or lack of knowledge about something, don't avoid talking about them! Your fears can grow and cause more stress and anxiety during your pregnancy that can absolutle affect your labor as well, so talk it out with your partner, doula, midwife, a friend, anyone who will listen really!

So let's recap into the five steps you can take today to feel more confident about home birth, if you maybe have concerns or are unsure about moving forward with a home birth.

1- Learn the Evidence: Look up studies and statistics on home birth safety for low-risk pregnancies.

2- Ask Questions: Discuss safety protocols, emergency preparedness, and transfer plans with your midwife.

3- Choose the Right Provider: Find a skilled midwife with experience and a strong track record of prioritizing safety.

4- Discuss Your Fears: Be open with your midwife about your concerns so they can address them with facts and reassurance. 

5- Weigh the Risks and Benefits: Consider both hospital and home birth risks to make a well-rounded decision.

Thank you so much for joining me today on Your Birth Bestie podcast! If you’ve been struggling with fears about home birth, I hope this episode has given you clarity, confidence, and reassurance to make the best decision for you.

Remember, birth is a natural and powerful process, and with the right care and support, home birth can be a safe and fulfilling option. If you’re looking for more resources, head to FamilyFocusedMidwifery.com, where I have free guides, blog posts, and more to support you on your journey.

I have a virtual group coaching program starting on March 1st if you're interested in chatting with me on Zoom and planning for an empowered and confident birth experience. Click on the link in the show notes for all the details on what's included!

Thank you again for tuning in and I will be back here next Tuesday with another episode. Bye everyone!