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Cost of Home Birth vs. Hospital Birth – Is Natural Home Birthing with a Midwife Right For You?

By Casey Slide

newborn babyI’m really fascinated by birth stories. It’s absolutely exciting to hear how a baby enters the world and all the circumstances surrounding the event. While I’ve heard some great stories, the most interesting ones involve home births. I’m intrigued by the concept, but I’m also a little hesitant to pursue such an endeavor myself.

All of that aside, another thing I often wonder about home births is whether or not they are cost effective. Even without taking birth location into account, having children takes financial consideration. After all, you’ll want to plan for the best time to have a baby.

Taking into account all of the advantages and disadvantages, does it make sense from a financial aspect, to have a home birth? I’ll go through each one of the pros and cons, and give a “cost” (or value) for each. See if you agree with me.

Pros

1. The Experience

Women who give birth at home most often enjoy the experience. They are able to have their baby the way they want without the pressure of medications and the interference of a hospital setting. There are no rules and no monitors strapping them down. The mother does not have to endure routine medical interventions; she, alongside her support system, is in control. The Experience = Priceless

2. No Temptation

For women who want to give birth naturally, doing so is easier at home than in a hospital. Most simply, the mother does not have ready access to anesthesia or narcotics, and therefore does not have the backup available when the going gets tough. An added benefit to natural birth is a quicker recovery time. No Temptation = Varies by the individual

3. Support Group

A woman giving birth at home can choose the people who are present for the experience. Typically, that includes a midwife and possibly, a doula. A midwife is a Masters level nurse who has been trained specifically to deliver babies. A doula gives encouragement and support to the mother during labor and birth through massage, coaching, and other techniques. These are people that a woman knows and trusts. At a hospital, a woman may have several nurses if she is in labor over shift change. Support Group = Varies by the individual

4. No Hospital Bill

Since a home birth is not in a hospital, there is no hospital bill. In addition, there is no anesthesia bill or nursery bill. No Hospital Bill = $0

5. Expenses (If Woman Is Without Insurance)

The main expense of a home birth would be the midwife. She could charge anywhere from $1,500 to $3,000. Typically, home births are not covered by insurance, so there is a good chance that this would be an out-of-pocket cost. To put that in perspective, all the bills from the birth of my son added up to around $700 after insurance was applied (otherwise it would have been more like $10,000).

You never want to go without health insurance, but if you don’t have it, a home birth could save you a lot of money. Other than the midwife, the other expenses include supplies, labs, and a doula. A doula’s services range in cost from a few hundred to a thousand dollars. Expenses = Between $1,500 and $5,000 (Compared to $10,000+ at a hospital)

Cons

1. Emergency Situations

Home births are safe as long as the woman has had a healthy pregnancy, and the baby is thriving. However, there is always the risk of an emergency situation arising. In the event of a home birth emergency, the delay in care could have grave consequences. My son was a meconium baby and needed immediate respiratory care by the NICU staff upon his birth. If we were not at the hospital when he was born, my son could have had long-term health problems or worse. I had a healthy pregnancy, but for whatever reason, the situation presented itself. Emergency Situations = Costly

2. No Postpartum Medical Help

One of the best things about being in the hospital is getting help from the staff. Nurses and Patient Care Techs are very caring individuals who are there to help you recover. If you have a home birth, you will not have this type of help unless you have family members willing to stick around. No Postpartum Medical Help = Varies depending on the woman’s family

3. No Time Away From Home

When you are in the hospital, you are away from your home and your other kids. If you have a home birth, you are still in that environment, and it would be more challenging to remove yourself from the role of wife and mother. Some women would want to get away from their home for a day or two. Other women may not like that at all. No Time Away From Home = Varies by the individual

4. Expenses (If Woman Does Have Insurance)

If a woman does have insurance, and her insurance will not pay for a home birth, she will be paying considerably more for the home birth. If a woman’s insurance will pay for the home birth, she may be paying about what she would for a hospital birth. Expenses = Between $1,500 and $5,000 (Compared to about $1,000 at a hospital)

Other Options

1. Birthing Center

For the woman who wants an experience similar to home birth, she has the option to go to a birthing center. A birthing center encourages natural birth and allows the woman to have more control in the decision making. If an emergency should arise during the birth, it can be handled more quickly than at home. Also unlike the hospital, the woman and baby go home a few hours after the baby has been born. The cost is somewhere between that of a home birth and that of a hospital, and it is usually covered by insurance.

2. Hybrid Approach

Another alternative is for the woman to labor at home, and go to the hospital right before giving birth. It would be wise to have someone assist the woman with laboring at home, such as a doula. Also, it’s advantageous if the hospital is close to home and the route is well-known. This is a good option for women who want a natural birth but want the help of a hospital staff during and after the birth.

Final Thoughts

The cost effectiveness of a home birth is dependent upon the woman and what she values most. It is also dependent upon her comfort with taking risk.

Although home births are safe in general, there is some amount of risk involved. I am not one for risk-taking, and because of the previous incident with my son (which is fairly common), I would opt for another hospital birth rather than a home birth. However, I would consider a birthing center, as it seems to be a good compromise between the two ends of the spectrum.

As far as the actual dollar amounts are concerned, I am not sure that there is a big enough difference to impact most decisions on where to give birth. The best way for a pregnant woman to save money on medical expenses is to live a healthy lifestyle and remember to take her vitamins!

What is your take on the costs of home births? Have you or someone you know had experience with home births?

(photo credit: Shutterstock)

Casey Slide
Casey Slide lives with her husband and baby in Atlanta, GA. She graduated from the University of Florida in 2005 with a bachelor’s degree in Industrial Engineering and worked for a prominent hospital in Atlanta. With the birth of Casey’s son in February 2010, she decided to become a stay-at-home mom. Casey’s interests include reading, running, living green, and saving money.

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  • http://liverealnow.net Jason@LiveRealnow

    I’ve got 3 kids and I was pretty hands-on for each of their births. Barring emergencies, I’d be reasonably comfortable delivering another. I can even go beyond “catch”. I can deal with the cord, whether it be cutting it or taking it off of a neck. I can deal with afterbirth and minor dilation problems.

    Would I WANT to? No, but I’m a good guy to have around after the zombies come. :)

    • Casey Slide

      Yes, knowing how to do all that is great, but having to do all that is another story, right?! Thanks for sharing, Jason!

  • Tim @ growrichsimply.com

    Great post. One other option if you’d like the to get some of the benefits of the home birth, but without some of the drawbacks (or risks), consider delivering with a medical mid-wife at a hospital.

    My wife did this for one of our children and she says it was by far the best experience she had. A medical mid-wife is essentially someone who has a master’s degree in nursing, but who specializes in midwifery. They are much more holistic than your standard OB/GYN, but they deliver in hospitals using lots of natural techniques (and, they’re more affordable!)

    Highly recommended.

    • Casey Slide

      Thanks for adding that, Tim! I have also heard great things about medical midwives. Midwives typically spend more time with the mother during labor than a doc who may only come in to “catch” the baby. Thanks for sharing your wife’s story!

  • http://www.thecentsiblelife.com Kelly

    Interesting post. I have 4 children, all of whom were born at a birth center. The cost was less than a hospital birth, but also less expensive than paying out of pocket and being partially (or not) remibursed for a homebirth by our insurance. It really will vary greatly on what if anything your insurance covers.

    It’s interesting but I actually got more support by having them at a birth center and subsequently going home 6 hours later. The reason? The birth center had classes to help you learn to take care of the baby (not just the birth portion) as well as a new mother’s group that meets once a week. This actually set up lifelong friendships for my son, and me. The nurses came to my house twice, and I called and spoke with my care provider every day for a week, and then anytime I needed to ask a question. I can’t imagine a typical doctor would take that time to talk to a patient after birth.

    Home birth is not riskier than hospital birth, and in my experience and based on the research I have done (I studied to be a doula, and considered midwifery) hospital birth can actually CAUSE some of the issues that are emergencies. While that may not be true in every case, hospital births are managed much differently than homebirth or in a birth center setting.

    Since every individual differs I would highly recommend checking into a birth center option, or having a midwife attend your birth in the hospital as an alternative if you’re not comfortable/able to birth at home.

    Want to really be inexpensive though? There are women that birth on their own completely-no midwife, no caregiver. It’s called unassisted birth. Their only cost is a birth kit which averages around $200-300.

    • Casey Slide

      Oh yeah, I didn’t think to mention an unassisted birth. I saw a show on Discovery Health on that once.

      I am very much interested in birthing centers, but unfortunately, the closet one to me is about 5 hours away. That would be a downside to them that they are not located everywhere.

      That is great to hear about all the support that you received at the birthing center! Thank you for sharing your story!

    • Casey Slide

      Oh, and I definitely agree that SOME hospital births cause emergencies, not all though. I used to work at a hospital so I know a little bit about how they run. It is a business.

  • http://change-is-possible.net Heather

    Home birthing appeals to me, but I’m already in my mid-30s (and not pregnant), so it would make me nervous. I’m planning to look for the medical midwife or a birthing center. Hopefully one or both are available in this area.

    However, it would cost me more than $1000 to have a hospital birth, and I am insured. (My deductible is $2000, plus copays.)

    • Casey Slide

      Good luck to you, Heather! I do not have a birthing center in my area so hopefully you are not near Atlanta. Insurance plans are all different so my article is based on averages.

      • http://change-is-possible.net Heather

        Thanks. I’m in Phoenix.

  • Christy L

    My personal choice is a hospital birth. If I were to live near a birthing center, I would consider that as well. I think that what people forget is that they are the customer at the hospital. At least in our area, hospitals work hard for customer loyalty and market share and they will listen to your requests.

    If you have a discussion with your doctor about what you want and don’t want, have a documented plan for the hospital, meet with a hospital staff member before hand, and have an advocate at the hospital with you – you can have the natural birth you want. You have the right to refuse medical procedures, monitoring, etc – as long as you are aware of the benefits and risks of doing so. Education is key.

    • Casey Slide

      Great advice, Christy!

  • http://www.prairieecothrifter.com Miss T @ Prairie EcoThrifter

    Great post. Where I live, I want to do a hybrid approach. I am going to have a midwife but be delivered in a hospital or birthing centre so I am good in case of emergencies. I haven’t been pregnant yet, but that is the plan. I would love to do home birthing but I don’t think my husband wants to take the chance.

    • Casey Slide

      Yeah, you have to have a support system to do a home birth, and if your husband is not willing, then it is probably not a good idea. Good luck to you!

  • http://www.instant-loan.com/ Stan Sloan

    I wouldn’t advise home birth for a first time would be mother. It is always best for first timer to give birth on a hospital. But for those experienced and did not have any complications in the past, they may do away with home birth as long as they were properly checked up by a doctor.

    • Casey Slide

      Good point, Stan!

    • Caitlin T H

      I am a first time mother who had a home birth. The experience was everything I hoped it would be. Women have been giving birth in their homes for thousands of years. What has changed that suddenly makes it better to be in the hospital environment. I think that taking the confidence away from women is the harmful thing here.

    • Joe Hinkley

      If you are a first timer, there is a + – 50% chance you will have a c-section in a hospital. Thereby making a home birth for your subsequent births more complicated because of your c-section. Best to just stay home if you are healthy.

  • Mamaerin

    I am pregnant with baby #8. I had my oldest almost seventeen years ago, at home. I was eighteen and had watched my mother give birth at home to my five younger brothers. It was not a question in my mind where I was going to be most comfortable, homebirth, hands down! I had an amazing experience. I had my second baby come three months early (emergence c-sec), and for that reason we had the next two in the hospital. No homebirth Midwife or Dr. would do it at home. These were the two most frustrating, out of controll, uncomfortable and awful births I’ve had. The Dr. decided how HE wanted it to be, it had nothing to do with my birth plan or desires. My babies were removed immediately, and until I left the medical staff felt that this was their baby, not mine. I HATED it. The next three were at home, surrounded by my family and close friends. I walked to the park in hard labor, I had my children completely involved from begining to end, and it was WONDERFUL. My last two were born in birth tubs, and I was able to rest and recoup in my home, in my bed, and had my family there. In the hospital I did not get rest, there was always someone bugging us, and taking my baby to stick em or weigh them. Home has been nothing but beautiful and wonderful. The hospital was nothing but depressing and such bad memories. Also, a hospital birth costs an aprox $10-15,000, but home is aprox $5000. And insurance companies are covering more and more.

  • Mamaerin

    also, a little comment to add to the above Doula info-
    I am also a birth Doula, and childbirth educator. I charge $400 to Doula, which is close to most of the certified Doulas I know. The most I have heard anyone charge was still under $1000, and that was a three day birth. I have never heard of more. I also do births at no cost if it is a teen mom, or a family that cannot afford help. There is plenty of homebirth help both through Midwives and Doulas that are FAR cheaper than anything in a hospital. The average I hear, cost wise, is that homebirth tends to be about a third of a hospital birth. And, as I already stated, insurance companies are covering most homebirths these days. I have had no issues with this in the past. After insurance the most I’ve owed, out of pocket, in any of my homebirths has been $300. No complaints here!

    • Casey Slide

      Your comments are very informative! Thank you so much, and good luck with baby #8! I’m a big fan of big families!

  • GLB

    My husband and I are discussing having a 4th child, my previous deliveries have been in a hospital and I have not had any complications, and really no complaints. I do have a desire to have a home birth and was very curious about the cost difference. With my previous births we were active duty military, and the cost was about 20$, so things are different now, and the cost is one of the concerns that my husband has brought up. Thank you, this article was very helpful for me!

    • Casey Slide

      I am so glad that this article was helpful for you. Good luck with baby #4!

  • Sarahshort88

    There is a birth center called Blessed Birth in Greenville,SC- not 5hrs away from ATL :) no personal experience but I am interested in it when I finally do have children. Excellent reputation and reviews, and about a mile from two major hospitals in the area.

    • Casey Slide

      Not sure I would want to drive 5 hours while in labor! Might end up delivering in the car! Thanks for sharing!

  • zonnia

    Postpartum care is available depending on your midwife. I am considering doing a home birth and the midwives in this area stay with you 4 hours after birth for any help you need with the baby and then come back the next day or two to check in. They also provide breast feeding consultation for a significant time after birth.

  • Elizabeth Allen

    I really appreciate that you present both the pros and cons of out-of-hospital birth – few resources are so brave! Many books and blogs lead women to believe that there are no cons to out-of-hospital birth. While many women deliver successfully outside of the hospital every day, some do not. We do women a great disservice if we don’t give them good information related to transferring to the hospital. A great resource for helping women understand the issues of getting to the hospital is “Laboring Well: A labor nurse shares insights from 10,000 births”.

  • Joe Hinkley

    Home births are covered by insurance in Florida and many other states where it is normal to birth at home. Some midwives do not accept insurance because of the trouble getting paid for services. Medicaid pays them right away. Insurance payment to the midwife can take months… and yes, postpartum care is a part of EVERY midwives model of care and it’s quite extensive. More so than your OB in most cases.

  • Gabbi

    In some instances naturopathic midwives are used and postpartum doulas as well. Naturopathic midwives are trained as doctors and can help with postpartum recovery for mom and for the family

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