A small number of women choose to give birth at home, at home, with a midwife. How does a home birth go? Is it riskier than giving birth in the hospital? What you need to know about home birth.

Fear of being dispossessed of one of the great moments of their existence, desire to give birth to their baby at her place, to live the moment of birth just with the father and a midwife… Here are the reasons which explain the choice of future mothers to give birth at home. They are very few in number: less than 1% of births in France.

Who can give birth at home?

Home birth is a scheduled home birth. In addition to the parents’ desire, several conditions must be met:

• The mother must have had a good state of health before the pregnancy (no diabetes or hypertension for example)
• The pregnancy is going perfectly well: no gestational diabetes, high blood pressure, bleeding …
• Previous pregnancies and childbirth should go well
• Pregnancy is a singleton (one baby) pregnancy with one baby presenting upside down
• Home birth should take place between 37 and 42 weeks.

Note: Any pathology during pregnancy must lead to a consultation or a transfer to another professional. If gestational diabetes or high blood pressure is diagnosed, medical follow-up is mandatory. The DAA project must be abandoned.

The woman who wishes to give birth at home is warned of the risks involved and is informed of the possible need for a transfer to a maternity hospital if there are complications during the birth.

Home birth is part of a comprehensive support approach: it is the same liberal midwife who will ensure the follow-up of pregnancy and childbirth, the follow-up of childbirth and after-birth. Liberal midwives who practice DAAs are listed by the National Association of Liberal Midwives (ANSFL).

The couple wishing to follow up a pregnancy and have a home delivery must find a liberal midwife practicing DAAs from the beginning of the pregnancy. If the conditions to authorize an DAA are met, the midwife provides personalized follow-up throughout the pregnancy, is present for the delivery and provides postnatal follow-up.

Note: The National Association of Liberal Midwives (ANSFL) has established a charter for home births.

The liberal midwife ensures the follow-up of the pregnancy within the framework of a global support. This follow-up is identical to that carried out by a doctor or a midwife: prenatal consultations and ultrasounds (prescribed by the midwife). The midwife within the framework of an AAD also offers birth preparation courses.

When the mother-to-be begins to be in labor, she calls on the midwife who follows her. This ensures a presence throughout childbirth.

Epidural anesthesia is of course impossible (it requires an anesthesiologist). The midwife can give massages to relieve the pain of the contractions.

A transfer to the nearest maternity hospital can be made for medical reasons (baby in pain for example) but also if the pain is not supported by the mother or if the parents request it.

Home birth: follow-up after childbirth

The midwife who performed the home birth monitors the woman who has just given birth and the newborn for at least 2 hours. She is the one who carries out the baby’s first aid, and even she who carries out the post-natal follow-up of the mother and her baby, for a week (her visits are covered by Social Security for 7 days).

The occurrence of a life-threatening emergency (bleeding during delivery in particular) and risks associated with transfer delays. The main risks remain linked to long medical intervention times. The risk is all the greater as the hospital structure is far away.

Home births are not recommended by the College of French Obstetricians and Gynecologists or by the College of Midwives.