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Home Birth & NC, What's the Deal?

Updated: Nov 4, 2020

Since Covid 19 there has been a 500% increase in home births nationwide, I have gotten a lot more inquiries and questions about home birth and wanted to share how it works in NC and SC.

First off, let's talk about the benefits of home birth.

They are beautiful to experience and witness. There is a connection that is felt with all of the women through generations that have given birth at home, it is real, deep and it feels like you belong to the best sorority in history.

Comfort, we feel more comfortable and safe when we are in an environment that we know, this allows our bodies to release fear and accept what is happening. You can wear whatever you want or don't want and the groove of labor is not interrupted by transferring to a hospital. There is not a time frame pressed upon you that causes panic.

Food, you can eat and drink whatever you want during labor, in fact it is encouraged. Labor is called that because it is work. Your body needs fuel to do the work and the only way to get that is by eating.

More family and friends can attend the birth if you want, there are no restrictions in place limiting the number of people, with that being said, birth usually happens once there are less people, it is a sacred space. If you have other children and you want them to be a part of the event, they can be.

Birth is looked at as a natural experience, not a medical one. It is a lot more natural at home and peaceful, romantic even. The intimacy with your partner can really be felt at a home birth, your partner will have a new sense of appreciation for you and you them.

Water birth, you can deliver in the birth tub at home, in NC the only other place you can deliver in a tub is at a birth center. Water births are called the midwife's epidural for a reason. I have never had a client say they don't like the tub.

Recovery, you can lay in your own bed right away, you don't have to be in the hospital where it can be difficult to sleep. Bonding with the baby is uninterrupted. The midwives have all of the things needed for a newborn screening and it is done right next to you.

Postpartum care with a midwife is very intentional, they stay for the fist several hours after delivery, then come check on you 1 day after delivery, then again on days 3, 7, 10, 14 and 6 weeks postpartum.

Some things to think about with home birth are:

Medication, you cannot have a epidural or narcotic pain medication at a home birth. It is something that needs to be prepared for mentally, the pain has a purpose, but it is still pain and you need to have a game plan in place for how you will handle it. It is a nice idea to be out of the hospital, but do you understand all that it entails? Is your partner and family members on board, because if they are not, it is very difficult to have a successful home birth.

Transferring to a hospital is something that may need to happen, that is a conversation that you need to have with your midwife so that you understand how that would happen and in what circumstances.

Cost, the cost for a midwife in the Charlotte is typically $4,000. You can try and get your insurance to reimburse your payment, many locals have been able to do it successfully, but that is on you to tackle not the midwife. On average this is less than most hospital births once all the bills have come in. For hospital births you pay the percentage your insurance requires you to pay, the numbers I am using were what we paid for my last: to the OB Practice $800, are then billed for triage room $400, delivery room $400, postpartum room$1,000, all medications$500, anesthesiologist $1,200, epidural $500, pediatrician$300, audiology $300, urologist $300 (if circumcising) and none of this includes possible Operating room or NICU fees. According to recent surveys, on average clients pay about $7,000 for a hospital birth after insurance.

Legalities, it is legal for you to deliver at home in NC, but it is illegal for a Certified Professional Midwife (CPM) to attend the birth because they are not offered licensure In N.C. Certified Nurse Midwives (CNM) can legally attend. The burden lies on the midwife and that is why they do not publicly advertise or seek out business. They do this because they want options for birthing people, they take great risk and ask that you understand that risk.

Doula care, a midwife is not a doula and vice versa, there is a very important role for each in home birth. The midwife focuses on the clinical side of things, the health of the baby, and birthing parent, how labor is progressing. The Doula is responsible for the physical and emotional comfort of the birthing parent, we make sure they feel they are in a safe space that allows their body to relax enough to bring the baby down. Sometimes when there is no doula, the midwife or her assistant take on this role, but they love when doulas attend their clients births. Doula care can also be reimbursed through insurance as long as your doula has an NPI number. Most local doula's also offer payment plans and sliding scales, we want to make sure you have the support if you want it. Another benefit of doula care in a home birth is that if you have a need transfer, here in Charlotte they can go with you to the hospital as long as it is a Novant hospital and they are an approved vendor.

If you are considering a home birth here are some questions to ask yourself:

  1. Why do I want a home birth?

  2. Am I prepared for the financial investment?

  3. Does my partner support the idea of a home birth?

  4. Am I prepared for the work I would have to put in during labor?

I love home birth and think it is a beautiful option, if I was a low risk pregnancy and having more children, I would have one in a heart beat.

If you have any questions or would like to be put in touch with some local midwives, just let me know.

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