Triangle Birth Network
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Childbirth Choices :: Choosing a Birth Place

Birth Center | Hospital | Home Birth

Is it safe?

Home birth used to be the standard in this country, and continues to be in some other developed countries, many of which have lower maternal and neonatal mortality rates than the United States does. But today in the U.S., only about 1 percent of women choose to give birth at home. This is not for lack of safety—indeed, studies have continued to demonstrate that for low-risk mothers and babies, home birth with the assistance of a skilled, qualified birth attendant is as safe or safer than hospital birth. Women giving birth at home typically have fewer vaginal lacerations, far fewer cesareans and other medical interventions. In addition, their babies have been found to have higher APGAR scores (indicating better newborn health condition)1. Even the American Public Health Association recognizes home birth as a safe and viable option for most women2.

Is it legal?

Many people think that home birth is “illegal” in North Carolina. This is not true. It is legal for any mother to give birth in her own home. Where the legality issues come into play is with the care provider; in North Carolina, the most common attendants of home birth—certified professional midwives, or CPMs—are not legally licensed by the state to attend births. This does not mean that CPMs are not qualified to attend home births. The CPM credential is issued by the North American Registry of Midwives, or NARM, and indicates that a midwife has achieved a safe level of practice, with its attendant education and training. For more information about certified professional midwives, go to Midwives Alliance of North America or the North American Registry of Midwives.

It is legal for any licensed care provider to attend home births as long as they meet meets the state’s requirements to do so. This means that any physician, or any certified nurse midwife with a physician back-up, may attend home births legally. Unfortunately, in our area, there is only one CNM practice regularly attending home births.

So, who is a good candidate for home birth?

Healthy, low-risk women who feel most comfortable in their own homes surrounded by their families, friends (and own sheets!) may be happiest with a home birth. Obviously, home birthers must be women who do not wish to receive an epidural, since regional anesthesia is most definitely not available at home. This doesn’t mean that you have to be a martyr or have an amazing pain tolerance to give birth at home. For many women, being in their own space, own clothes, and own bed do a lot to make the pain of birthing more manageable. In addition, a home birth does not set any limit to the amount of time you can spend upright, walking, in the tub or shower, or receiving massages from your partner, doula, or friends! Plus, women who are motivated by the idea of having significantly less medical intervention during their birth will likely feel safest at home.

Home birth practitioners will likely want to be sure that you are in good medical condition and that your pregnancy is within certain parameters of “normal” before agreeing to attend your birth at home.

Home birth may be a good option for women who have a lot of fear of hospitals or medical procedures, or who feel strongly that they would feel safer in their own home. Of course, any paralyzing fear should be addressed before birth, possibly with a qualified professional, since even a planned home birth may require transfer to a hospital in case of emergency. If this were to be necessary, it is essential that mothers and fathers have addressed their fears or anxiety about a hospital transfer beforehand.

For more information about home birth in our state, go to North Carolina Home Birth.

Some Studies on the Safety of Home Birth:

1. See Birth. 1997 Mar;24(1):4-13; discussion 14-6.

2. American Public Health Association. 2001-3: increasing access to out-of-hospital maternity care services through state-regulated and nationally certified direct-entry midwives. Am J Public Health 2002;92: 453-5