birth philosophy

Planning a home birth

The thing about making unusual choices is, people like to question those choices. Often in a tone best described as mildly accusatory. You know what I’m talking about. You’re doing what? Why would you do that?

So I’m sort of thrilled that home birth is more mainstream now than it was ten years ago, when we were expecting Abigail.

Back then, I fielded all kinds of interesting comments on the topic. More than once, other women told me I was sure to run to the hospital once I went into labor. “You’ll change your mind, you’ll see,” they would say. “Or else we won’t need you to tell us when your baby’s born, we’ll have heard you screaming from here!”

Um. Okay then.

That didn’t happen, obviously. The changing my mind thing, or the screaming thing. And now, having given birth at home once or twice (or four times), I can’t imagine choosing anything else under normal circumstances.

If you were to ask, I would tell you all the things I love about home birth, and about all our different births. I’d tell you how my opting for home over hospital isn’t about avoiding something so much as it’s about preferring something else. I’d tell you about how my experience is normal. Not universal, but normal. Not a fluke. Not just a lucky break. I would talk and talk and talk and talk, if you asked. (If you didn’t ask, I’d mostly leave you alone.) But I don’t really think of myself as a home birth zealot.

Here’s the deal. It’s fine with me if you don’t want to have a home birth. My goal isn’t to convince other people to do what I do. In fact, I think the issue of where and how to give birth is one of reproductive freedom, and thus I’m not interested in telling anyone else what to do.

But what I am in favor is this: I am in favor of all pregnant and birthing women being treated ethically, in any setting. I am in favor of women having access to accurate and complete information. I am in favor of women having the opportunity to use that information to make choices about their care. I am in favor of mothers being valued and respected as autonomous individuals, capable of making good decisions about their bodies and their babies. I am opposed to fear tactics, and to coercion, in any setting, with any care provider.

That all seems pretty reasonable to me. Not even terribly unusual. At least I hope not.

For more about birth and midwives, check out the birth resources page.


  1. says

    I think you are amazing. This post is amazing. And I have always had this thought on the outskirts of my mind that a homebirth would be amazing.

    It’s no secret that I long for another baby. Not sure if this will ever happen, but pretty sure a homebirth will never happen. So I admire those that speak so clearly, simply and strongly about. (Strongly? Is that even a word? Harumph!)

    • Melissa Camara Wilkins says

      Sarah: Totally a word! Though I’m cool with made-up words too, especially when you leave such lovely comments. :)

  2. says

    Even 8.5 years ago, it was so hard to find info about homebirth.

    I never considered homebirth because I’d never even really heard about it. The only person I knew who did it, had an Unassisted Birth at home, and the thought of having no one help with the birth scared the crap out of me. (I thought Unassisted Births were the same as home births — I had no idea that licensed nurse midwives actually attended home births.)

    • Melissa Camara Wilkins says

      Anjali, I once asked a midwife friend of mine who was pregnant with her second baby, if she planned to have an unassisted birth. She said (and I’m paraphrasing, this was years ago), “Are you kidding me? I remember what labor was like. I want my midwife.” :)

  3. says

    As a Berkeley resident since the early 90s, I always thought homebirth was pretty normal. That birth, in general, was something normal not something medical.
    I think some people choose home to avoid, and some, like you, choose out of preference. In my case, I’m choosing hospital out of preference, but only because the standard of care here is being in the water, with fetal monitoring only when necessary, unmedicated whenever possible, vertical birth with eating and drinking as mom can tolerate it. If my choice was a conventional hospital or home, I’d pick home in a minute. As it is, with a progressive hospital, I’m just choosing a bigger tub with unlimited hot water. ;-)
    So glad your experiences were good, and I’m sure this one will be, too.

    • Melissa Camara Wilkins says

      Naptime: Big tubs with plenty of hot water sound good. :)

      Of course there are plenty of things about hospitals/birth centers that I am glad to avoid. But there are also good things that are specific to homebirth, and that’s what was most important to me in this decision-making process.

      Also: Dude. What Megan said (below) about Berkeley and San Diego.

  4. says

    Amen, sister! After all the flak I got just for planning a natural midwife-assisted birth in a birth center the first time around, we kept our home birth choice quieter the second time — until it was done, then we proudly announced that our baby was born peacefully at home, in the water, surrounded by his family, with his cord cut by his dad and big sister. Nobody said anything then. :)

    Seriously, though, I so agree that our choices about how and where we birth are part of reproductive freedom, a very personal issue, and not one I believe others should get to decide for us. Then I go back to thinking about how the moment I first showed in my first pregnancy I became, without forewarning, open to all public comments (I was commuting on the Coaster then, so you can just imagine), and that has continued through the early years of child-raising.

    What is it about our reproductive ability that seems to spur such fear and judgement and unsolicited opinion in our culture? Hmmm, probably our power! Our incredible, immense, mind-boggling power in being able to grow a child inside of us and bring that child into the world (because, yes, we do that birth thing ourselves). So, rather than acknowledge that, let’s make sure we let the ladies know who knows better…

    OK, am I going off? Sorry, I’m going off. But you know I’m in your corner, my home-birthing, feminist, writer-mom, sister-friend (not to label you or anything). You go, girl. Speak truth to power and all that… ;)

    • Melissa Camara Wilkins says

      Megan, I’m with you. It’s bizarre to suddenly become the target of unsolicited advice and opinion about pregnancy, birth, parenting… especially since there are so many possible opinions to have, and often seemingly no way to find common ground. But I’m hoping everyone can agree, regardless of which opinions we all hold about birth, that women should be the decision-makers in their own care.

  5. says

    Very nicely said. I’ll admit that I’m not the best at self-education, and I have often left myself and my care in the hands of the medical community. Reading your explanation (and related posts) has made me realize how much I gave up to that community, and while I might have still chosen to have my children in a hospital–I did have excellent care, and a very positive experience–I would like to have known that it was because I CHOSE that road, instead of going down it because I saw no other.

    • Melissa Camara Wilkins says

      Diana, that’s just what I hope for, too: that pregnant and birthing women will have options, see those options, and choose the ones that best fit their particular circumstances and personal values. :)

  6. says

    Ladies, I would be happy if we brought a little more EarthMama to all of America, and got back to the pre-etherized-on-your-back-so-it’s-easier-for-a-man birth ways. Outcomes are better. What are we waiting for? Oh, right, the giant payment on those surgeries.
    My insurance won’t pay for a birth center or a doula, but now they will pay for a midwife. Hoo-freaking-ray, can I pocket the savings or will you be keeping that? Thought so.

    • Melissa Camara Wilkins says

      What, your health insurance isn’t giving you a rebate for choosing a less-expensive birth? Shocking, I say, shocking!

      Ah, money. :) The article we discussed last week also has an interesting bit about the relationship between money and birth outcomes, too. And this piece at rhrealitycheck talks about the fact that many women won’t have access to options in birth until and unless Medicaid starts covering birth alternatives. It’s always money, isn’t it? But short of a public health care system (which isn’t presently an option), how to demonetize riskier birth practices? Sigh.

  7. says

    Hi Melissa!

    Thanks for writing this note. I am a homebirther too after having my first babies in the hospital. And I am a healthcare worker, a respiratory therapist to be exact. Which you think would change my view of childbirth. It does not. I agree with you whole heartedly. Homebirthing was right for me but I understand that it’s not right for many. And in my province I paid for my homebirth. It was not covered by our universal healthcare plan. So I saved my government (an average of) $10,000/birth. I feel like I deserve a rebate (jk). I am just happy that in the last year this changed for the better, homebirthing is now funded by our healthcare plan, but good luck finding a midwife. That’s a whole post in itself!

    Anyhow. I was a mostly quiet homebirther in that I didn’t share my homebirth plans with a lot of people. A lot of people felt it necessary to comment about how scary it was that I would choose that option and I would feel it necessary to point out the increasing infant mortality rates and the increasing incidence of hospital-acquired infections. So mostly it was just better not to have the conversation in the first place.

    Plus I found that trying to convince people about how one’s body protects itself. That delivering without drugs was not excessively painful, that I avoided IVs, catheters, etc. and that my post partum recovery was much easier. Did not work. A lot of women seem determined not to trust their own bodies.

    Sorry for the rant like comment. Wishing you happy mostly comfortable pregnancy and a peaceful birth.

    • Melissa Camara Wilkins says

      Thank you, Shawna!

      I’m always surprised when people are hostile to the idea that birth can be a nonmedical event. I understand that bodies sometimes don’t work the way they’re supposed to, and that’s what intervention is for. But much of the time, birth can take place safely as a natural process. One wouldn’t think that would be an offensive notion.

  8. Abi says

    Amen Amen. And you know what’s funny is that maybe we should be talking about it more. Getting more positive homebirth stories out there in the collective conciousness (never could spell that word). Because right now the people telling stories at the drop of the hat are those with tales of fear and negativity about homebirthing. But why would we want to share our homebirth experiences with people (if they don’t ask, that is:) when in return we have to hear that “mildly accusatory” voice Melissa so aptly describes? Should we push through it for the good of women’s health at large? Tell our stories and grit our teeth for the inevitable reply? Maybe on a good day, just a little.

    • Melissa Camara Wilkins says

      This is a good point, Abi. There really isn’t any other way to influence the popular imagination.

      I do mention it when it comes up in conversation, but I don’t usually go farther than that unless someone asks. Except here. :) I don’t know if that’s enough. I think you’re right: on a good day, be more open. On a good day, be willing to deflect unwarranted judgment. And make more days be good days.

  9. says

    You are amazing, and thank you for sharing your positive stories, and your views on informed choice. I planned a home birth but got cold feet midway through and opted for a birth centre. Long story but I think my cold feet was actually the universe telling me, I should be closer to the hospital.
    As a midwife, I advocate for the choice of homebirth and am in awe of every woman who makes that choice. Not because they choose to birth at home, but because of the ‘negativity’ of others that you need to deal with when making your choice.
    In Australia, our current government is trying to ban home births, right when women are starting to become more informed and educated about what choices they do have.
    I think it’s about time we start hearing ALL the positive stories, rather than focussing on the negative ones.
    You are a *STAR* :)

    • Melissa Camara Wilkins says

      I’m with you– we need positive stories, to help define what birth *is,* and to envision the kind of care we want to receive during birth. So many people only know about birth from what they’ve seen on TV, or in the movies, and maybe from their own experience. Adding a variety of positive stories to that cultural cache can only help women as they make choices about their care.

      A good friend of mine just had a beautiful birth attended by an obstetrician who respected her wishes and her body. I think we need to hear stories like that one, as well as stories about skilled and compassionate midwives, to remind us that in any setting, with any type of provider, we are all entitled to respectful, competent care.