... candidate for a home birth, but the U.S. does not. The list below is taken from the criteria used in Janssen’s (2002; 2009) studies on home birth in Canada.

Women who are considered “low risk” and may be good candidates for home birth include the following (this should not be considered an exhaustive list):

• A woman who is pregnant with a single baby and has made an informed choice to birth at home
• Baby is head down at term
• Between 37 and 41-42 weeks pregnant (researchers differ on the 41-42 weeks)
• No serious medical conditions (heart disease, kidney disease, blood clotting disorders, type I diabetes, gestational diabetes managed with insulin, preeclampsia, or bleeding)
• No placenta previa at beginning of labor
• No active genital herpes
• No thick meconium
• *No prior C-section
• *Spontaneous labor

*Some research study guidelines also included women with one prior C-section (low transverse incision) and women who were induced on an outpatient basis (Janssen, 2009). However, because of the lack of data on safety, ACOG considers prior C-section to be an “absolute contraindication to planned home birth.” (ACOG, 2011)

... the woman gave included:

• Belief that home birth is safer than the hospital*
• Desire to avoid unnecessary interventions*
• Previous negative or traumatic hospital birth experience*
• Control over birth decisions and choices (want to avoid strict hospital rules)*
• Dislike of hospitals, doctors, or medically managed birth*
• Desire for privacy and to avoid strangers
• Trust in birth as a normal, healthy process
• Lack of separation from baby, easier breastfeeding initiation
• Preference for midwives as caregivers
• Increased options such as delayed cord cutting or water birth
• Decreased risk of Cesarean birth
• Comfortable atmosphere
• Family involvement during the birth (children can be present)
• Decreased risk of infection
• History of fast (precipitous) labor where it is difficult to get to the hospital in time

* indicates one of the 5 most common reasons stated

... in the birth. Many parents cannot or should not take on this responsibility. Women who choose a home birth must be willing to labor without an epidural.

... pregnancy and birth as normal life events. Midwives who practice using this model monitor a woman’s physical, psychological, and social well-being. They provide individualized education, counseling, prenatal care, hands-on assistance during labor and delivery, and postpartum support. When you receive care based on the midwifery model of care, you are less likely to experience unnecessary medical intervention or Cesarean birth, and you are more likely to feel in control during birth and to initiate breastfeeding. Midwives are trained to identify and refer women who experience pregnancy or birth-related complications. (Wiysonge, 2009).

In addition to receiving prenatal care from a midwife, women who choose home birth in the U.S. often receive collaborative care from a physician. This may range from a single visit for an acute need to a back-up arrangement for hospital transfer, to full collaborative care—in which the mother receives duplicative care from a physician and a midwife.