Welcome to Shiphrah Birth Services blog!  Thank you for joining me in my Home Birth Myths series.  So far, we have addressed home birth legality, safety, and the idea that home birth is just a trend.  This week we’re going to talk about the messy side of birth!
 
Myth #4: Home Birth is Messy!
 
Believe it or not, this is one of the hang-ups some people have when they’re considering a home birth.  Credit where credit is due, this usually comes from the male half of the expectant couple.
 
The concern here seems to be that birth, in all of its wonder, is far from clean.  I’ve heard people worry that there will be bodily fluids strewn throughout the house, and they picture placentas sitting in a bowl on the counter, used instruments sitting on their dresser, and a general unclean environment after the baby is born and the midwives leave.
 
Here’s the truth of the matter.  Birth IS messy.  Along with labor, you might (and usually do) see blood and other bodily fluids.  When baby comes, there’s more of that plus a placenta.  However, there’s something that many people forget to factor in.  Midwives.

Midwives are experts at containing messes while they’re happening so that the end ‘mess’ is manageable.  Midwives clean up the used chux pads, the bloodstains (we love peroxide’s magic!), the instruments, and the trash.  We even take care of your placenta, getting it ready to go if you’re having it encapsulated, putting it in the freezer if you’re saving it, and disposing of it if keeping it is not in your plan.  We help the new mom shower or bathe and change the bedding so that she can get into a nice, clean bed.  We also make sure to start a load of laundry before we leave, so used towels and cloths aren’t sitting around.
 
Along with cleaning up the birth mess, we clean up any messes we’ve made such as dishes that we used while at your home.  We also want to make sure that the mom, after all of her hard work, eats and drinks to replenish her energy.  This means that oftentimes before we leave, we’re in the kitchen, fixing mom some eggs and toast or another high protein meal.
 
So, is home birth messy?  It may be for a short time but when the midwives leave, the only evidence that a birth happened will be mama snuggling with her newborn baby.  And maybe a placenta in the freezer.

Welcome to Shiphrah Birth Services blog!  Thank you for joining me in my Home Birth Myths series.  So far, we have addressed home birth legality and safety.  This week we’re going to talk about another myth.
 
Myth #3: Home Birth is Just a Trend
 
A common perception about home birth is that only certain groups of people have their babies at home, or that it’s a short-lived fad.  These perceptions usually stem from a lack of knowledge about home birth and why women choose to have their babies at home.  These opinions come in the following or similar statements and often come from mistaken impressions about groups of people:
 

• Only Amish women give birth at home.
• No wealthy woman would give birth at home.
• Only rich women give birth at home.
• No college-educated woman would give birth at home.
• Only high school dropouts would choose to have a home birth.

 
There are many more variations of the above statements that simply are not true.  This is another myth that will require us to dig into studies to find accurate information.  Let’s get started!
 
The Midwives Alliance of North America (MANA) study that I referenced in Myth 2 is, once again, one of the best sources when it comes to statistics surrounding home birth.  This comprehensive study shows the following:
 

• 92% of women who choose home birth are high school graduates
• 58% are graduates of a 4-year college

 
This particular set of numbers is interesting to many people, especially those who assume that choosing home birth means you are uneducated and not very smart.  This belief often stems from those who haven’t yet learned that home birth is shown to be a safe option for low risk women.  The fact that college-educated women choose home birth is a fact that can influence the opinion of legislators who otherwise might prefer to make laws restricting the ability of women to legally choose to give birth at home.
 
The high school and college statistics also show us that it’s not just Amish or Mennonite women giving birth at home.  While many home births do take place in the Plain Community, home birth is not exclusive to the Amish or similar sects.   
 
The MANA study shows the following about payment methods for home birth:
 

• 64.4% of women self-paid (Please note that this does not mean they do not have health insurance)
• 24.2% utilized private health insurance for their home birth fees
• 8% of women who gave birth at home were on Medicaid or similar state insurance
• 3.4% paid with other methods

This information does not give income status of the women who gave birth at home, so my comments on this will be made from personal experiences with home birth clients as well as inferences from the above data.
 
Iowa Medicaid does not currently cover home birth providers so women who are lower income and on Medicaid are paying out-of-pocket or denied access to a home birth because of the lack of coverage.  Women who do have non-state insurance may choose to submit their costs to their insurance company and see if they can be reimbursed.  Some midwives in Iowa do accept insurance and utilize a biller who can help clients determine what kind of coverage they’ll have.    Most insurance companies will not cover 100% of the cost of home birth but many will pick up some of the cost.  Christian healthcare sharing companies usually cover home birth.  Samaritan Ministries is the best of all of them as they cover home birth without question and without requiring a deductible be met.  Home birth expenses are also considered qualified expenses for Health Savings Accounts (HSA) and Flex Spending Accounts (FSA).
 
The information from MANA as well as what I’ve seen in Iowa indicates that women across all socioeconomic groups are choosing home birth, with middle class women having more accessibility from a financial standpoint.  That said, many home birth clients do qualify for state insurance but because they believe home birth is the best option for them they will find a way to pay their midwife.
 
MANA also touches on the statistics of first-time vs. non-first time moms choosing home birth:
 

• 22.3% of women choosing home birth have never given birth prior to their current pregnancy
• 77.7% of women choosing home birth have given birth prior to their current pregnancy
• 9.2% of women choosing home birth have been pregnant 5 or more times

 
This is a pretty straightforward observation.  Women who are pregnant for the first time choose home birth at a lower rate than non-first time moms.  From a personal experience standpoint, this is often because women learn about home birth as an option after they’ve given birth, or they feel more comfortable giving birth at home after having already had a low-risk pregnancy and birth.
 
Who else gives birth at home?  Let me preface this by saying that one should never make important life choices based on what celebrities choose to do, but I thought you might enjoy seeing some of the actresses, singers, and models who have given birth at home with a midwife in attendance:
 

• Mayim Bialik (my personal favorite-a neuroscientist, actress, AND chose home birth?!)
• Melora Hardin (The Office, anyone?)
• Maya Rudolph (her first labor and birth went so fast that her first home birth was an unplanned home birth!)
• Alyson Hannigan (Most notable as Lily, from How I Met Your Mother)
• Julianne Moore
• Meryl Streep
• Demi Moore
• Pamela Anderson
• Cindy Crawford
• Ricki Lake (you might know about her birth from her documentary Business of Being Born)
• Alanis Morissette
• Jennifer Connelly
• Gisele Bundchen (your husbands might know of her husband-Tom Brady)
• Maria Bello
• Nelly Furtado
• Lisa Bonet

 
I hope that helps give a better picture of who chooses home birth.   If you have had a home birth and want to offer your insight, please feel free to comment on the blog post.
 
Source:
Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009
http://onlinelibrary.wiley.com/doi/10.1111/jmwh.12172/full