The average uncomplicated vaginal birth costs 68% less in a home than in a hospital, and births initiated in the home offer a lower combined rate of intrapartum and neonatal mortality and a lower incidence of cesarean delivery.

“The Cost-Effectiveness of Home Birth.” J Nurse Midwifery. 1999 Jan-Feb;44(1):30-5. Gee, what a novel concept — care that costs less but has a better outcome!

I did an informal survey of sources online to determine that the average hospital birth costs around $8,000 in the United States, depending on exactly where the mother lives. That does not include the additional costs of an epidural or cesarean section, nor does it include the prenatal care from a physician, which costs anywhere from $1,500 to $3,000. For the sake of discussion, let’s say the total cost of prenatal care and physician-assisted hospital birth is approximately $10,000. Compare that to my prenatal care and home birth with a midwife, which cost a total of $4,300. That’s $5,700 — nearly 60% — less! And I was far happier with my home birth experience than my two hospital birth experiences.

Guess how much of that $4,300 my insurance company covered? $2,947.08. Compare that to what the insurance company theoretically would have paid for physician-assisted hospital birth: $8,000! By that token, the insurance company should have been paying ME to have a home birth. My choice of home birth saved the company over $5,000. And the irony is, I had to fight to get the company to cover a home birth at all. Because there were in-network midwives who could attend births at a hospital, the insurance company initially denied my request for a homebirth. I had to have my midwife write a letter to the company stating that I had a “medical need” for a homebirth (basically we argued that I had had such bad hospital experiences — with a fourth-degree tear and a failed epidural — that for my mental health I needed a home birth!) Luckily, the company agreed to pay, although I had to pay 25% co-insurance, rather than 20% co-insurance for an in-network provider. In the end, I wound up paying about $450 less out of pocket for a homebirth, and had a safe and satisfying birth.

Post from: Breastfeeding 1-2-3

1. Never having to get in the car during labor or soon after the birth.

2. Getting to (being encouraged to!) eat and drink during labor.

3. Being able to open the windows for fresh air.

4. Resting completely undisturbed after the birth. No one woke me or the baby to check vital signs or for any other reason.

5. The baby was never separated from me (as my other children had been for a bath, a blood test, or a hearing screen).

6. No one ever tried to offer my baby a pacifier, glucose water, or formula.

7. My baby did not get dehydrated from the dry hospital air, and in fact she regained her birth weight in 3.5 days rather than the typical 10-14 days.

8. My older children got to participate in the birth and never had to be separated from me or my husband.

9. No one questioned my choices about vitamin K injections, antibiotic eye ointment, vaccinations, or co-sleeping.

10. I knew every person who interacted with me and the baby during labor, delivery, and the post-delivery period. I felt comfortable (and, well, at home!) throughout the entire experience!

For those who have had a home birth, what do you see as the advantages? Were you happy with your experience?

Post from: Breastfeeding 1-2-3

I called the midwife at 5:45 p.m. to give her a heads up, and then went about doing some last minute birth preparations. The contractions remained quite irregular, sometimes coming 15 minutes apart, sometimes only one minute apart. By 8 p.m. we decided to take my 6- and 3-year-old girls for a walk in the Baby Jogger to get the 3-year-old to sleep and also to see if walking helped labor along. It was a beautiful, warm California evening under a full moon! We laughed and wondered whether that moon had anything to do with the timing.

I was feeling a lot of pressure on my pubic bone and aching in my back, but the contractions remained short and irregular. I felt surprised by the slow progress because my entire labor with my second child had been five hours total, and here I was going on 6 hours and not even ready to call the midwife to come!

Shortly after 10 p.m. I had four contractions in 11 minutes. I called the midwife at 10:23 p.m. Of course, right after that my contractions slowed down again: 7 minutes, 8 minutes, 8 minutes, 5 minutes, 12 minutes, 10 minutes…. I started to worry that the midwife would arrive, check me for dilation, and inform me I wasn’t ready for her stay. When she and her assistant arrived at 11:30 though, my contractions immediately kicked back into high gear: 3 minutes, 3 minutes, 2 minutes. My body had been waiting for help to arrive! The midwife didn’t even do an internal exam anyway. She simply assessed the baby and took my vital signs, and went about setting up her birth supplies. At our home visit earlier in the day she had asked about my preferences during labor — did I want a lot of hands-on support or did I prefer to be left alone? In accordance with my wishes, the midwife and assistant soon retreated downstairs, leaving my husband to support me and to finish filling the birth tub.

By midnight I was in the tub, and again we were laughing to ourselves. “Can you imagine if we were driving to the hospital right now instead?” Our kids were sound asleep in the next room, and there I was luxuriating in the warm water. Things were going just as I had hoped.

I had long stopped timing contractions, and I simply focused on breathing and rocking through them. I imagined myself “blowing” the cervix open with each exhale. I silently cheered myself on. “This pain is the good work of pushing the baby out! Relax and let your body do what it knows how to do. You are doing it!” By 1:30 a.m., staying silent wasn’t enough. I started to make low growling sounds and I told my husband it was time to summon the midwife back upstairs. By 2 a.m. I had a flashback to my hospital experience with my second daughter, when I absolutely could not sit still for the nurse to insert an IV. As it turned out then, I was complete and ready to push, but we didn’t know that until the doctor finally arrived 15 minutes later. This time, I knew I was about ready to push, and I had my husband awaken the children.

The 3-year-old was quiet and alert. The 6-year-old just wanted to keep sleeping on our master bed, but the midwife assured me she would perk up when the energy in the room changed, as she knew it would when I was ready to give birth. The assistant checked the baby’s heart rate, and then the midwife did the one and only internal exam of the entire labor. She confirmed I was complete and ready to push at 2:30 a.m.

I was relieved it was time to push and I found pushing to be preferable to the previous stages of labor. Still, I found it difficult to focus my energy. A hand at the right place helped show me where to concentrate my efforts, and soon I could feel the baby making progress. I alternately grunted or held my breath through the pushes as the midwife guided me through how hard to push. She knew I didn’t want a fourth-degree tear like the first time, or a second-degree episiotomy like the second time. Just as she was saying that the skin was very tight and she might need to perform an episiotomy, out popped the baby’s head! That surprised all of us, and I felt a rush of relief and joy. It makes me cry as I think of it now! It was 2:51 a.m. as the rest of my beautiful girl slipped into the water. The midwife caught her and handed her to me on my chest.

The baby hardly cried, but she was already pinking up and clearly healthy. She scored 10/10 on her Apgar scores. I snuggled her warm in the water as I delivered the placenta. My older girls took the opportunity to express their amazement. They felt the umbilical cord pulsing. They touched the baby’s toes and that made her open her eyes, much to their delight.

As the midwife carried the baby to the bed, my 6-year-old said, “I love that pink baby!” I got out of the tub and joined the baby to nurse. She nursed off and on for an hour, switching sides three times! She was alert and content and just the most wonderful thing to see!

After an hour of that bonding time, the midwife and assistant examined the (as yet unnamed!) baby at the end of the bed. She was healthy in every way. I was amazed that she didn’t fuss as they moved her around, weighed her and measured her. She was 7 pounds 2 ounces, 19.5 inches, with lovely features and a beautiful, round head. She hardly looked like a newborn — she looked more like the day- or two-old babies seen on television births.

As it turns out, I had torn exactly where the doctor had done the second-degree episiotomy. The skin simply couldn’t stretch where the scar tissue was. So I received 5 internal stitches and 6-7 external stitches.

Someone later asked me whether the whole experience had been painful or hard or scary. I answered that for me, the labor had been all three. But at the same time, the experience was peaceful and glorious. It had gone exactly how I wanted, and both the baby and I were safe. That is what I hope for every woman — the power to choose the setting for her birth and the good fortune to have the experience and outcome desired.

Post from: Breastfeeding 1-2-3

To see the results of the last poll, click here.

Post from: Breastfeeding 1-2-3