Who does it, who attends it, who pays for it?
The term “home birth” refers to having a planned birth at home. If we travel back far enough in anyone’s ancestry, all of us come from people who gave birth at home. It is still done, but there is a lot of confusion about it so here are some facts about having a baby in a home setting, particularly in Ontario.
Home birth is not new, and neither are midwives. It took a long time for regulation and legalisation of Registered Midwifery (RM) to catch up here in our province and other provinces across Canada. Universities slow to offer enough spaces for the demands, Premiers fighting against fair wages for Midwives, general public misinformation about midwifery practice, and other obstacles to growing the industry exist. Midwives are the traditional providers of care for birth in low-medical settings such as at home, but they do also work in hospitals with birthing clients (you can even get an epidural or start an induction with an RM, those are different practitioners who give anesthesia, and medications like Pitocin are continuously monitored in hospital by midwives.)
Toronto has a birth centre too, and it also is only attended by RMs as it is only equipped to provide a safe space for low-risk and low-intervention seeking pregnant people.
Registered Midwives are covered by OHIP if one qualifies and can find an available Midwife. There are pockets of areas where people are unreachable to the available midwives, or there just isn’t enough of them for all the people interested in this option. Some pregnant people get fixated first on the hospital they want to be at and then try and get a midwife that has privileges there, and that’s not how eligibility is determined (usually goes by home address and then the hospital option is the one where that midwife goes).
When working with an RM, one receives regular prenatal visits and assessments, gets sent for ultrasounds and referred to specialists if/when the need arises. If something happens to elevate a person’s risk in pregnancy, the RM might recommend switching birth venue plans to be in hospital.
With a Registered Midwife in Ontario, homebirth is an option for people who want to stay out of a hospital, perhaps are too far from a birth centre (we only have 3 in the whole province), or people who want to birth in the comfort of their own home because they trust they don’t need the other interventions available in a medical setting.
Stay tuned for part two which discusses free birth, hospital births, and birthing centers details.