Read Part 2 Of This Article On Delivering Your Baby At Home
What if you need a c-section?
It's rare for a woman to suddenly need a c-section. Generally, there's ample warning. Most c-sections are performed for "failure to progress" and are not true medical emergencies.
Surgical teams must be assembled; they have to scrub in; and you must be prepped. If your midwife determines that you have, for example, a prolapsed cord and need a c-section, she will transport you to the hospital according to her protocols. She will likely call the hospital to let staff know you are on the way so that they're ready for you when you arrive.
When you plan for a homebirth, you need to be responsible about it; part of that responsibility means arranging a backup plan. You might consider touring the hospital ahead of time to find out what the procedure would be if you are brought in for an emergency c-section. If you have a backup physician, that's great, but remember: In an emergency, you'll get the on-call doctor anyway.
What if you can't handle the pain?
It is rare for a woman to be transported because she needs pain relief. Granted, no one knows ahead of time what kind of labor she will have. But you can prepare yourself mentally. Childbirth classes will teach you various natural techniques for pain management. Water can alleviate a lot of the pain of labor. Massage and acupressure may help you, as may hypnosis. Labor support is crucial, and prevention is the best medicine: good nutrition, including adequate mineral intake, and exercise during pregnancy go a long way toward a smooth labor.
If you believe firmly in your ability to give birth naturally, you will probably find a way to do it. But some women find that the pain is simply too intense for too long, and this is typically a sign that something is not right. Your midwife will recognize this and may recommend transporting you to the hospital. This is where a backup plan comes in handy. Let your body guide you -- but surround yourself with supportive people. It is natural to feel that you can't go on at nine centimeters dilated, moments away from birth. A few well-timed words from your husband or your midwife may be all the encouragement you need to have your baby at home, naturally.
Being in a hospital does not guarantee that you will receive pain relief. Only an anesthesiologist can administer an epidural. If the anesthesiologist is busy, you'll have to wait. If you're not dilated enough, you'll have to wait. If you're already at 10 centimeters, it's too late.
Choosing to use pain relief certainly does not make you a failure, nor does it make your birth experience any less valid. But many women find there is something empowering, on a very primal level, about natural childbirth.
Isn't it illegal to have a baby at home?
In the United States, it is perfectly legal for you to have your baby at home. No one can press charges against you for such a choice. In some states, however, direct entry midwives can be arrested for attending a homebirth. Your midwife will know if what she is doing is legal. If your midwife cannot legally attend your birth, you may want to consider other options, perhaps delivering at the home of a relative in a more midwife-friendly state.
Midwives cannot legally attend homebirth in all 50 states. If this angers you, do something about it. Contact your congress people here as well as your state representatives. Write letters, organize petitions, make phone calls, get out and march for your cause.