Home Birth
Home Birth With a Midwife: What to Know
Choosing a home birth means giving birth in a familiar environment with a trained midwife who provides clinical care, continuous support, and a clear plan for hospital transfer if needed. Here's what the evidence says about safety, what to expect, and how to prepare.
What Is Home Birth?
A home birth is a planned birth that takes place at your home rather than a hospital or birth center. You're attended by a trained midwife — typically a Certified Professional Midwife (CPM) or a Certified Nurse-Midwife (CNM) — who provides all clinical care during labor, monitors the health of you and your baby, and manages the delivery.
Home birth is not the same as an unplanned or unassisted birth. A planned home birth involves prenatal care, risk screening, a backup plan for hospital transfer, and a qualified provider with medical equipment at your side. It's a deliberate choice backed by a care team and a transfer protocol — not a free birth.
In the United States, home births account for roughly 1–2% of all births, but that number has been growing steadily, especially since 2020. More families are seeking out-of-hospital options for low-intervention, person-centered care.
Eligibility
Is Home Birth Right for You?
Home birth is appropriate for low-risk pregnancies with a qualified midwife and a hospital transfer plan. You may be a good candidate if:
You have a singleton pregnancy with a vertex (head-down) baby
You're between 37 and 42 weeks gestation at the onset of labor
You have no major medical complications — no preeclampsia, gestational diabetes requiring medication, placenta previa, or history of preterm birth
You live within a reasonable distance from a hospital (typically under 30 minutes)
You have a qualified midwife lined up with hospital transfer arrangements in place
If you have a high-risk pregnancy — twins, breech presentation, prior cesarean (for some midwives), or chronic health conditions — most midwives will recommend a hospital birth. This isn't a failure. It's the system working as it should: matching your risk level to the right level of care.
Home Birth Safety: What the Research Shows
The largest and most rigorous U.S. study on home birth outcomes is the Birth Place Study, published in the New England Journal of Medicine in 2014 with follow-up data in 2019. It examined over 16,000 planned home births and found that for low-risk pregnancies, planned home birth with a CPM is a safe option with outcomes comparable to hospital birth.
Key findings from the Birth Place Study
- Neonatal mortality: Among planned home births attended by CPMs, the neonatal mortality rate was comparable to low-risk hospital births — approximately 1–2 per 1,000 births, within the same range expected for low-risk hospital deliveries
- Transfer rate: About 10–12% of planned home births resulted in transfer to a hospital during labor or postpartum. The majority of transfers were for non-emergency reasons: prolonged labor, maternal exhaustion, or request for pain medication
- Intervention rates: Home births had significantly lower rates of medical intervention — including induction, augmentation, episiotomy, and cesarean section — compared to hospital births for similar low-risk populations
- Satisfaction: Over 90% of families who planned a home birth reported being satisfied with their experience, and the vast majority said they would choose home birth again
- Vaginal birth rate: Among planned home births that did not transfer, the vaginal birth rate exceeded 95%
The bottom line on safety
For low-risk women attended by a qualified midwife with a hospital transfer plan, planned home birth is a safe option — not more dangerous, not more risky, just different. The evidence supports that when you match the right person to the right setting, outcomes are comparable. The key is the screening, the midwife's training, and the transfer plan.
What makes home birth safe
Research consistently identifies four factors that determine home birth safety:
- A qualified midwife — CPMs and CNMs are trained to manage normal birth and recognize complications
- Appropriate risk screening — only low-risk pregnancies should plan a home birth
- A transfer plan — your midwife establishes a relationship with a nearby hospital before your due date
- Proximity to a hospital — most guidelines recommend living within 30 minutes of a hospital with obstetric services
When all four are in place, the data shows outcomes that are comparable to low-risk hospital birth. When they're not — for example, a high-risk pregnancy at home with an unlicensed provider — the risks increase significantly.
What a Home Birth Midwife Does
A home birth midwife is not just present for the delivery. She provides comprehensive care throughout your pregnancy, birth, and postpartum period — the same scope as a CNM or CPM providing prenatal care, just in your home rather than a clinic or hospital.
Prenatal care
Home birth midwives typically provide all your prenatal visits — usually 10–12 over the course of your pregnancy, lasting 30–60 minutes each (compared to the typical 10-minute OB appointment). This includes:
- Vital signs, fundal height, fetal heart rate monitoring
- Lab work ordering and review
- Ultrasound referrals if needed
- Nutritional counseling and pregnancy education
- Risk screening at every visit — your midwife will transfer you to hospital care if complications develop
- Emotional support and birth preparation
Labor and birth
When you go into labor, your midwife comes to you. She monitors your vital signs and the baby's heart rate intermittently with a fetal Doppler, assesses your progress, provides comfort measures, and manages the delivery. She stays for several hours after the birth to ensure you and your baby are stable.
Postpartum care
Home birth midwives typically visit you at home at 24 hours, 3 days, and 1–2 weeks postpartum, plus a 6-week checkup. This is far more postpartum contact than the standard hospital model, which often sends you home within 24–48 hours with a single 6-week follow-up.
"My midwife spent an hour with me at every prenatal visit. She knew my preferences, my fears, my partner's name. When I went into labor, I didn't have to explain anything — she already knew."
— Rachel M., home birth mom, Colorado Springs
Preparation
Home Birth Supplies & Preparation
Preparing for a home birth involves gathering supplies and setting up your space. Your midwife will give you a supply list early in the third trimester. Here's what's typically involved.
What you'll need to provide
Your midwife will typically ask you to order a birth kit (available from suppliers like Informed Beginnings or Cascade Health Care for $30–$60) and gather household items:
- • Waterproof sheets and chux pads for your bed and floor
- • Plastic drop cloths to protect flooring
- • Thermometer
- • Bulb syringe for the baby
- • Peri bottles and postpartum pads
- • Old towels and washcloths
- • Trash bags and a designated waste container
- • Birth pool (if planning water birth) — rental or purchase
- • Heating pad or warm rice socks
- • Snacks, electrolyte drinks, and water
What your midwife brings
Your midwife arrives with a full medical kit designed for safe out-of-hospital birth. This typically includes:
- • Fetal Doppler for intermittent heart rate monitoring
- • Blood pressure cuff and stethoscope
- • Pulse oximeter
- • Oxygen and neonatal resuscitation equipment
- • Pitocin (for postpartum hemorrhage management)
- • IV supplies and fluids
- • Sterile instruments, suture materials, and local anesthetic
- • Hemostats, cord clamp, and scissors
- • Glucometer and urine dipsticks
- • Emergency medications and protocols for transfer
Your midwife will handle the medical side. Your job is to create a comfortable space and gather the comfort items that matter to you.
Your Search
Finding a Home Birth Midwife
Your midwife is the single most important factor in a safe home birth. Here's how to find a qualified provider:
- Search the NARM directory — The North American Registry of Midwives lists Certified Professional Midwives (CPMs) by state.
- Check your state midwifery organization — Most states with CPM licensing have a state midwifery association with a provider directory.
- Ask for referrals — Local birth centers, doulas, and parenting groups often know reputable home birth midwives in your area.
- Interview multiple midwives — Most midwife practices offer a free initial consultation. Ask about their training, transfer rate, backup arrangements, and hospital relationships.
- Verify licensure — In states that license CPMs, confirm your midwife's license is active and in good standing.
Find home birth midwives in your area — browse our birth support pages for Denver, Colorado Springs, and other cities.
Common Questions
Frequently Asked Questions
Is home birth safe?
For low-risk pregnancies, planned home birth with a qualified midwife is supported by research as a safe option. The Birth Place Study (2014), the largest U.S. study on home birth outcomes, found that planned home births attended by CPMs had neonatal mortality rates comparable to low-risk hospital births. Key safety factors include a trained and licensed midwife, a low-risk pregnancy, a clear hospital transfer plan, and proximity to a hospital. Home births also have significantly lower rates of interventions like induction, episiotomy, and cesarean section.
What if something goes wrong?
Home birth midwives are trained to identify complications early and initiate hospital transfer when needed. About 10–12% of planned home births result in transfer to a hospital, and the vast majority of transfers are for non-emergency reasons like prolonged labor, maternal exhaustion, or a request for pain medication. Your midwife carries emergency supplies including oxygen, pitocin for hemorrhage management, and IV fluids. She also establishes a transfer plan with a nearby hospital before your due date so that if you need to transfer, there's a clear path — not a panicked rush.
Can I have a home birth after a C-section (VBAC)?
VBAC (vaginal birth after cesarean) at home is controversial. Some CPMs will attend a home VBAC for candidates they consider low-risk, but many will not due to the small but real risk of uterine rupture (approximately 0.5–0.9%). The American College of Obstetricians and Gynecologists (ACOG) recommends that VBAC be attempted in a facility capable of emergency cesarean delivery. If you're considering a home VBAC, discuss your specific risk factors with both your midwife and a physician — and make sure you understand the worst-case scenario and your hospital's transfer capabilities.
What does a home birth midwife bring?
A home birth midwife brings a full medical kit, including: a fetal Doppler for monitoring the baby's heart rate, a blood pressure cuff and stethoscope, a pulse oximeter, oxygen and neonatal resuscitation equipment, pitocin for postpartum hemorrhage management, IV supplies and fluids, sterile instruments and suture materials, local anesthetic, hemostats, cord clamps, scissors, a glucometer, and urine dipsticks. This is clinical-grade medical equipment — not a first-aid kit. Your midwife is prepared to manage complications and stabilize while awaiting hospital transfer if needed.
How much does a home birth cost?
A home birth with a midwife typically costs $3,000–$9,000 depending on your location, the midwife's credentials, and what's included. This usually covers all prenatal visits, the birth itself, and postpartum care (including home visits). For comparison, an uncomplicated hospital vaginal birth can cost $10,000–$30,000+ before insurance. Many home birth midwives offer payment plans, sliding-scale fees, or barter arrangements for families who can't afford the full fee upfront.
Does insurance cover home birth?
Coverage varies significantly. Medicaid covers home birth midwives in some states — this is expanding, but it's not universal yet. Private insurance is inconsistent: some plans cover CPM-attended home births, some cover only CNM-attended births, and some exclude out-of-hospital birth entirely. The trend is toward expanding coverage, but you'll need to verify with your specific plan. Your midwife's office can usually help you check your benefits, and some states have advocacy organizations that assist with insurance claims for home birth.
Plan your home birth with confidence
Whether you're planning your first home birth or exploring your options, a birth plan helps you communicate your preferences clearly to your midwife and your support team. Build yours free in the app.