Of course the cesarean deliveries weren’t performed at home; after the labor be­gan, about 12 percent of women who planned to deliver at home needed transport to a local hospital. For this reason, I believe that the key to choosing a home birth is the speed with which state-of-the-art emergency support can be ob­tained if needed.

Although there may be appealing advantages to delivering a baby at home, we know this choice is not for everyone, or even for most women. When exploring all possible locations for the best delivery for you, keep in mind that there are some disadvantages to a home birth. For example, a home birth is generally attended by a midwife rather than a physician, and therefore you may not be able to receive medical help as quickly if an emergency arises. If your labor is especially difficult and long, for example, you may not be able to receive medications that could reduce your pain if your birth attendant is not licensed to administer pain medications. Or, if the baby experiences fetal distress or if your health becomes endangered and therefore a cesarean delivery becomes necessary, you will need transportation to a nearby hospital. If you are considering a home birth, make arrangements to be able to have emergency backup so that you can go from decision to incision within thirty minutes if needed. Think carefully about the pros and cons before making your final decision.

The decision is up to you. Many healthy babies have been born in the comfort of their own homes, and some families may strongly desire to plan a home-based labor and delivery. If the mother has a low-risk pregnancy and if the family has a backup arrangement with a physician and nearby hospital in the event of an emergency, home birth can be a viable option, with the added advantage that the expectant couple can control the environment to include the green elements that are important to them.