Hey, Whose Birth Is This, Anyway?

Dear Mr. Dad: We’re about to have a baby and my wife is trying to convince me to have a home birth with a tub of water. I just don’t feel comfortable with this idea and would really rather just go to the hospital and deal with a regular doctor. I’m worried about what could happen if something goes wrong. My wife is getting irritated that I won’t do things her way. What should I do?

A: First, let me congratulate you and your wife for being brave enough to talk about this. I deal with a lot of parents and it always amazes me how long couples wait before having serious discussions. And given that having a baby will change everything in your life, the topic of childbirth is about as serious as it gets.

A little context. Back in 1940, 56 percent of babies were born in hospitals. In by 1950, that number had risen to over 80 percent, and in 1969, it hit 99 percent where it’s been ever since. Over the past 10 years or so, though, the number of home births has risen “dramatically,” although that depends on your definition of the word. Home births are indeed up by 20 percent, but considering they started at one percent, an increase to 1.2 isn’t much in real numbers.

Have you asked why your wife wants to have the baby at home? Does she think it’s a safer alternative? Does she want more privacy, freedom to move around, and to minimize interventions? Does she want more familiar surroundings? Did she have a bad experience at a hospital? It’s important that you find this out in a completely non-judgmental way. Just listen to what she has to say.

Most hospitals and clinics these days have pretty homey birthing centers with couches and flat screen TVs. But they’re still medical facilities and they won’t be as familiar—or as private—as your own home. There is some research that shows that for low-risk pregnancies (her doctor will tell you whether or not she fits into this category), home births can be just as safe as hospital births. In fact, at home, there may actually be less likelihood of labor induction, medication, episiotomy, and c-section. But the operative phrase here is “low-risk,” which will be determined by her age, health, and whether she has or has had any health issues or other risk factors that might require medical intervention.

In the end, the goal isn’t to “win” the argument, it’s to achieve the safest birth possible, right? And even though home birth vs. hospital birth seems kind of black and white, there are really many shades of grey in between. For example, if it turns out that what’s most important to your wife is to give birth in the water, check with her doctor and the hospital where you’re planning the birth. They may have waterbirthing facilities, which would give her the environment she wants and give you the security of knowing that there’s a whole team of medical professionals nearby in case you need them.

All in all, I suggest that you, your wife, and her doc schedule a time to talk this over. If you trust him to deliver your baby and care for your wife, you should be able to trust his opinion on whether a home birth—in or out of the water—is safe. At the end of the day, though, keep in mind that your health insurance may home the ultimate trump card. Some plans cover home births, but many don’t.

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