A home birth means giving birth in your own home, with a trained midwife present. In many countries this is a legal option, though it sits outside the standard hospital-based maternity system.

Planned home births with a midwife account for roughly 0.3–2% of all births in high-income countries, with rates varying significantly by country and region.

Who Can Have a Home Birth?

Not everyone is a candidate for a planned home birth. Evidence-based guidelines set clear criteria for who can safely choose this option. You must be what is called low-risk.

Eligibility Criteria

To be considered for a home birth, you typically need to meet these requirements:

Single baby in a head-down position — not twins or other multiples
Normal, uncomplicated pregnancy without known complications
Completed routine prenatal care
No known medical conditions in you or the baby that increase risk
Spontaneous labor onset between 37+0 and 41+6 weeks
Measurements within normal ranges
BMI within a healthy range (most guidelines use 18.5–35)
No previous cesarean section
For first-time parents: carefully assessed on an individual basis

Important: These criteria are not exhaustive. Your midwife makes a thorough individual assessment. Distance to the nearest hospital is also part of the evaluation — living far from emergency obstetric care may make home birth inadvisable.

Who Should Not Plan a Home Birth?

You should not plan a home birth if you:

Have had a previous cesarean section
Have gestational diabetes, preeclampsia, or other pregnancy complications
Are carrying twins or multiples
Have a baby not in a head-down position
Have significant health conditions
Live very far from a hospital

How to Plan a Home Birth

Planning should start early in pregnancy. The earlier you begin, the better prepared you'll be.

1. Discuss It With Your Provider Early

Bring up your desire for a home birth at your first prenatal visit. This gives you an overview of what's available in your area and lets the assessment process begin.

2. Find a Home Birth Midwife

Home births are attended by independent midwives. Availability varies significantly by region — urban areas generally have more options than rural ones. Search for certified nurse-midwives (CNMs) or certified professional midwives (CPMs) in your area who offer home birth services.

Start your search early — home birth midwives are often fully booked.

3. Create a Written Agreement

Your agreement with the midwife should cover:

Fees and payment schedule
Number of prenatal appointments included
When the midwife will be on call for you
Services included (birth attendance, postpartum care, prenatal care)
Plan for hospital transfer if needed

4. Write a Birth Plan

A birth plan is valuable for home births too. It gives your midwife a clear picture of your wishes and ensures you've thought through key decisions in advance.

Practical tip: Even if you're planning a home birth, arrange backup at the nearest hospital. It provides peace of mind if transfer becomes necessary.

What Does a Home Birth Cost?

Home birth is typically not covered by standard health insurance in the US and many other countries. Costs vary, but you can expect:

Midwife fee: $3,000–$6,000 USD on average (includes prenatal visits, birth attendance, and postpartum follow-up)
Some insurance plans do cover home birth — check your specific plan
Hospital backup: There should be no cost if you need to transfer (your hospital insurance applies)

Exact costs depend on your location, insurance coverage, and the specific midwife you choose.

Midwife preparing equipment for a home birth in a calm living room

Is Home Birth Safe?

This is the big question, and the answer is nuanced. Research and professional organizations have varying perspectives.

What the Research Shows

Evidence reviews from high-income countries show that planned home birth with a midwife for low-risk pregnant people:

Does not result in higher rates of serious adverse outcomes for the baby compared to hospital birth
Results in lower rates of medical interventions and complications for the mother
Has lower intervention rates — fewer cesareans, less epidural use, less labor augmentation

Major midwifery professional organizations support access to planned home birth for low-risk people.

Transfer to Hospital

Not all home births end at home. The midwife continuously monitors the situation and can decide to transfer.

Approximately 10–15% of first-time parents planning a home birth are transferred to hospital during labor
Approximately 3–5% of people who have given birth before are transferred
Most common reason: Slow progress in labor

This shows the system is working: the midwife identifies situations where hospital care is safer. Transfer is not a failure — it's part of the safety net.

Complications can develop quickly: Rapid access to emergency medical care can be life-saving for both mother and baby. This is an important reason why distance to the hospital is part of the evaluation.

Unassisted Home Birth — Strongly Discouraged

Giving birth at home without a midwife or other healthcare provider is not recommended by any major medical or midwifery organization. The risk of catastrophic outcomes is significantly higher. Always ensure a trained professional is present.

Benefits of Home Birth

Familiar surroundings: You give birth in your own home, with familiar sounds and smells
Full control: You decide on lighting, music, temperature, and who is present
One-to-one care: The midwife is there solely for you throughout
No travel: You don't need to make a journey during active labor
Lower intervention rate: Fewer interventions such as vacuum or cesarean
Continuity of care: The same midwife through pregnancy, birth, and postpartum

Limitations and Disadvantages

No medical pain relief: Epidurals and nitrous oxide are not available
Time delay for complications: Transfer to hospital takes time
Cost: You pay most costs yourself in many countries
Limited availability: Few midwives offer home birth, especially outside cities
Not an option for everyone: Strict eligibility criteria rule many people out

What You Need at Home

Your midwife will give you a detailed list, but these are commonly needed:

For the birth:

Clean towels and sheets (old ones you don't mind ruining)
Waterproof covering/plastic sheet for the bed or floor
A warm room (it should be warm for the baby)
Good lighting (the midwife needs to see)
Drinking water and light snacks for you

For the baby:

Soft baby washcloths and towel
Diapers and baby clothes
Hat (newborns lose heat through their heads)

The midwife brings:

Medical monitoring equipment
Oxygen and resuscitation equipment for newborns
Equipment for managing hemorrhage
Doppler/stethoscope for monitoring the heartbeat

Use a contraction timer: Keep track of your contractions using a contraction timing app. It helps you know when to call your midwife. Most home birth midwives ask you to call when contractions are regular, about 5–7 minutes apart.

Postpartum Care After Home Birth

After a home birth, your baby is entitled to the same healthcare as babies born in hospital. Your midwife will:

Complete a newborn health examination
Register the birth with the relevant authorities
Inform your primary care provider and local health services
Ensure the baby receives necessary follow-up and vaccinations
Provide postpartum follow-up for you (usually at least four consultations, including two in the first days after birth)

Home Birth vs. Hospital Birth: A Comparison

	Home Birth	Hospital Birth
Pain relief	Natural methods	Full access to epidural, nitrous oxide, etc.
Intervention rate	Low	Higher
Emergency capacity	Limited, requires transfer	Immediately available
Cost	Significant out-of-pocket	Covered by insurance/NHS
Care	One-to-one	Shared among multiple patients
Environment	Home, familiar	Hospital, unfamiliar
Availability	Limited	Universal

Frequently Asked Questions

Is home birth legal?

In most Western countries, yes. Planned home birth with a qualified midwife is legal. The legality and accessibility of independent midwifery varies by country and state. Check the regulations in your specific location.

Can first-time parents have a home birth?

Yes, if you meet the eligibility criteria. But be aware that transfer rates are higher for first-time parents (approximately 10–15%). The risk of unexpected complications is higher than for people who have given birth before.

What happens if something goes wrong?

The midwife continuously assesses the situation. If complications arise, you are transferred to the nearest hospital. The midwife accompanies you in the ambulance and hands over care to the hospital team. This is why proximity to a hospital is an important factor in the assessment.

How do I find a home birth midwife?

Search for certified nurse-midwives (CNMs) or certified professional midwives (CPMs) in your area through professional midwifery organizations. You can also ask your current prenatal care provider for referrals. Start searching early — availability is limited.

Does the midwife need an assistant?

Most guidelines recommend that the midwife have someone available to assist during the birth. This doesn't necessarily need to be another midwife.

Sources

WHO. "WHO recommendations: Intrapartum care for a positive childbirth experience." who.int
ACNM. "Position Statement: Home Birth." midwife.org
Cochrane Review. "Planned hospital birth versus planned home birth." cochrane.org
Birthplace in England Collaborative Group. "Perinatal and maternal outcomes by planned place of birth." BMJ, 2011.

Home Birth: Everything You Need to Know