This pregnancy took a turn I did not see coming.
At 27 weeks into my fourth pregnancy, I made the decision to switch from planning a birth center birth to preparing for a home birth.
It was not impulsive. It came after weeks of poor sleep, emotional processing, re-reading research, and talking through every “what if” with my husband and care team.
EPISODE 34 | HOLISTICALLY WELL PODCAST: WHY I SWITCHED FROM A BIRTH CENTER TO A HOME BIRTH AT 27 WEEKS
Whether you learn best by listening, reading, or watching, there is something for you! You can catch the full conversation on the Holistically Well Podcast—available on all your favorite platforms!
🎧 Holistically Well Podcast on Apple | Episode 34
🎙️ Holistically Well Podcast on Spotify | Episode 34
💻 Holistically Well Podcast on YouTube | Episode 34
Should You Have a Home Birth? A Complete Decision-Making Guide
In this blog, I want to walk you through:
- The exact questions to ask your provider as you explore your options
- Why I switched birth settings in the third trimester
- How my first three births shaped this decision
- What current evidence says about home birth safety for low-risk women
This is not about convincing you to choose home birth. It is about helping you feel informed, grounded, and confident in choosing the setting that feels safest and most supportive for you. I truly feel that when you understand your options, you can choose from a place of trust instead of fear!
Quick disclaimer: This is for education, not individual medical advice. Always talk with your own provider about your specific risk factors and options.
What My Hospital Births Taught Me About My Body
Before I ever considered home birth, I had three hospital births with midwives at a large academic medical center. I genuinely loved that midwife team and had really positive experiences overall.
Birth #1: Long labor and an epidural I truly needed
- 24 hours of active labor after a stretch of prodromal labor
- Needed a balloon catheter to help my cervix finally respond to contractions
- After 18 hours in the hospital and two nights without sleep, I chose an epidural
- Once my pelvic floor relaxed, I slept for two hours, woke up fully dilated, and delivered
Looking back as a pelvic floor PT, I can see that I did not know how to relax my pelvic floor. I was fighting the contractions instead of softening into them.
At that point, being in a hospital with access to an epidural was exactly what my body needed. I am very glad I was there.
Birth #2: Almost a car birth
- Light contractions all day at work
- Labored at home for as long as I safely could
- At 2 a.m., I felt a big shift in my pelvis and the urge to push
- We drove to the hospital, skipped triage, and went straight to labor and delivery
- Baby was born within 15 minutes of arriving, with me on all fours
We did need some smart positioning (cranking hip internal rotation) to help release his shoulders, but overall, this was a fast, unmedicated vaginal birth that easily could have happened at home if I had not been planning hospital delivery.
Birth #3: Standing birth in the hospital bathroom
- Premature rupture of membranes at 38 weeks with a slow leak of amniotic fluid
- No contractions at first, and I declined Pitocin
- Used nipple stimulation + walking circuits to bring on labor
- By evening, I was in transition while they were filling the birth tub
- My water fully broke when I went to the bathroom
- I began to deliver the head on the toilet, stood up into a supported squat, and delivered standing in the bathroom
Again, this was an unmedicated birth that unfolded very quickly once my body decided it was go time!
What these three births showed me
- My body responds strongly once labor truly starts
- My second and third labors were fast and low-intervention
- For my first, I am grateful I had hospital tools available
- I learned that your prior birth history matters when deciding future birth settings
These experiences are part of what gave me confidence to even consider home birth this time.
How Our Move Changed My Birth Options
After baby #3, we moved about two hours away from the city into a more rural area.
That meant:
- I could no longer stay with the midwife group I knew and trusted
- My options became: a birth center an hour away or the local rural hospital
I chose the birth center, because their model felt the closest to what I had in Columbus: a midwifery-led, physiologic-birth-focused team.
When “Good Enough” Care Doesn’t Feel Good Enough
Every single visit for this pregnancy at the birth center, I saw a different provider.
The patterns that started to bother me:
- No one seemed to have read my chart before walking in
- I had to retell my story every single time 🧐
- No one was really helping me optimize my outcomes in this fourth pregnancy
- Appointments felt like: hear the heartbeat, take my blood pressure, and send me on my way
As a holistic orthopedic and pelvic floor PT, I am very comfortable talking about supplements, nutrition, movement, pelvic floor prep, and birth mechanics.
I am always happy when clinicians want to learn, but I am also paying for care and wanted to leave visits feeling:
- Seen and remembered
- Confident about my plan
- Better equipped to support my body
That was not happening.
Around 24 weeks, I started seriously wondering:
“Is this the team I want by my side when I’m in labor?”
The Gentle Nudge Toward Home Birth
At the same time, I was seeing:
- Patients who had delivered at the birth center
- Patients who had delivered at the local rural hospital
- Patients who had home births
I listened to their stories. I watched their recoveries. I heard how they felt about their care.
Over time, a quiet thought kept coming up:
“Maybe home birth is for you.”
This surprised me. I was trained in a traditional medical model. For a long time, I carried internal stories like:
- “Home birth is irresponsible.”
- “Why would you choose not to be where all the best care is?”
But as I learned more, I realized it is not that simple. The “best care” is not always about the biggest building or most machines.
Is Home Birth Safe? What the Evidence and Context Say
Here is the simplified version of what I found, especially for low-risk women:
- For healthy women with low-risk pregnancies and a licensed, skilled midwife, planned home birth is associated with:
- Fewer interventions (C-sections, epidurals, episiotomies, inductions)
- Better maternal outcomes in many cases
- Higher maternal satisfaction
Safety improves when:
- You are integrated into the healthcare system
- You have had standard prenatal labs, anatomy scan, blood pressure monitoring, etc.
- Your midwife has clear transfer plans and relationships with local hospitals
- You are truly low risk and screened appropriately
In my case, most of my first two trimesters were spent with a hospital-based midwife team. So:
- The hospital already has my medical records, blood type, anatomy scans, lab work, and blood pressures in their system
- If transfer is ever needed, the hospital is not starting from zero with me
That integration was a big piece of feeling safe with this switch.
Who Might Be a Good Candidate for Home Birth?
This is not a complete list and is not a substitute for medical screening, but generally ideal home birth candidates are those who:
- Have a low-risk, singleton pregnancy
- Do not have uncontrolled chronic conditions (such as uncontrolled hypertension or diabetes)
- Do not have preeclampsia or active significant complications
- Are willing to:
- Work with a licensed, experienced midwife
- Prepare their body for labor and birth
- Follow guidance around transfer if needed
Some women with higher-risk factors (twins, breech, etc.) do still choose planned home birth, but that changes the risk profile and requires a very experienced team and clear transfer plans.
The key is honesty and alignment. The key is honestly assessing your risk and aligning with a team that is transparent about when home is appropriate and when hospital is safer.
Questions To Ask If You’re Considering Home Birth
Whether you are considering home, hospital, or birth center, you deserve clear answers.
Here are questions I recommend bringing to your provider:
About your risk profile
- “Do you consider my pregnancy low risk?”
- “Are there any factors that would make you cautious about home birth for me?”
- “What would be your main concerns if I chose home birth?”
About the midwifery practice
- “Are you licensed and what training do you have?”
- “How many births do you attend each month?”
- “How often do you transfer to the hospital and for what reasons?”
About transfer and emergencies
- “What are your criteria for transfer during labor?”
- “What are your criteria for transfer after birth (me or baby)?”
- “Which hospitals do you typically transfer to?”
- “Do you have relationships with staff there?”
- “What equipment and medications do you bring to a home birth?”
About pain management and support
- “What non-medical pain management strategies do you recommend?”
- “How do you support positioning and movement in labor?”
- “Do you encourage doulas or additional support people?”
About continuity of care
- “Who will actually be at my birth? How many midwives are on the team?”
- “Will I meet all of them during prenatal care?”
These conversations can be clarifying, whether you ultimately choose home, birth center, or hospital.
Home, Birth Center, or Hospital? A Simple Comparison
Home Birth (with licensed midwife)
- Pros:
- 1:1 or in my case 3:1 attention (3 providers come for me as the single patient!)
- Familiar environment
- No routine interventions
- High continuity of care
- Do not have to drive while in labor
- Cons:
- Requires transfer if complications arise
- Not appropriate for all risk profiles
Birth Center
- Pros:
- Home-like environment with more equipment on site
- Typically midwifery-led
- Often lower intervention rates than hospitals
- Cons:
- May still have some institutional policies
- Not all centers are close by
- You still have to travel in labor
Hospital
- Pros:
- Immediate access to surgical and NICU care if needed
- On-site pain management (epidural, etc.)
- Cons:
- Higher intervention rates in many settings
- Less personalized environment
- Shift changes and less continuity of care
None of these are “right” or “wrong.” The best choice is the one that fits your medical needs, your history, and your nervous system.
Preparing for a Home or Unmedicated Birth: Why Body Prep Matters
No matter where you deliver, if you are planning an unmedicated or low-intervention birth, preparation matters.
Some of the most powerful tools:
- Breath work to tap into your parasympathetic nervous system and ride each contraction
- Pelvic floor awareness, especially learning to truly relax, not “tighten”
- Perineal mobilization to help tissues adapt to the stretching of birth
- Functional strength training so your body can handle the positions, squats, and movements of labor
- Mobility work to help baby navigate the pelvis more easily
These are exactly the areas I guide women through in my Holistically Well Pregnancy Program. It is especially important if you are:
- Hoping to reduce the need for interventions
- Desiring a natural childbirth no matter the setting
- Planning a home birth or birth center birth
- Wanting to feel prepared instead of “winging it” in labor
You can explore all that inside the program, including breathing drills, positions, and strength sequences designed with pregnancy and birth in mind.
If You’re Sitting in the “In-Between”
If you are currently:
- Torn between hospital, birth center, or home
- Feeling something tugging at your heart that you cannot shake
- Waking up at night replaying “what ifs”
You are not alone.
Here is your gentle next-step checklist:
- Reflect on your history
- Prior births, health conditions, how your body tends to labor
- Prior births, health conditions, how your body tends to labor
- Clarify your values
- What feels safest to your nervous system?
- What kind of support do you want in the room?
- Book a conversation
- With your current provider: “Am I a good candidate for ___?”
- With a home birth midwife or birth center team, if that is on your radar
- Evaluate the evidence and your intuition
- Both matter. Facts and feelings can sit at the same table.
- Both matter. Facts and feelings can sit at the same table.
- Prepare your body for birth
- Whether you stay where you are or pivot, your body will thank you for intentional preparation.
If you want a structured path to that body prep, you can join my Holistically Well Pregnancy Program, where we dive into breath work, pelvic floor, strength, and mobility to support your labor, delivery, and recovery.
If you have your own story of switching care or weighing your birth setting, I would truly love to hear it. You can always connect with me on Instagram at @drkaylaborchers or reach out through drkaylaborchers.com.
No question is off limits. You deserve informed, respectful, holistic care in the season you are in!
