Book Review: Home Birth on Your Own Terms by Heather Baker

Today I’m sharing my thoughts about the book Home Birth on Your Own Terms: A How To Guide For Birthing Unassisted (2nd edition, 2019) by Heather Baker, and I am so excited to be writing this review! The book is catered to parents who would like to have an unassisted childbirth — meaning with no medical providers — and I was delighted to read it because I have had an unassisted childbirth or “freebirth” myself (albeit accidentally) and truly feel after that experience that there is not enough knowledge about this option.

First — why this book is important

The reality is that many parents accidentally have freebirths. I’ve actually met two women who gave birth in parking lots, and you can believe that neither of them planned that!

Unassisted childbirth, when accidental, can leave a range of emotions in its wake. One of the parking lot birthing moms I know was traumatized by her experience; for the other (who was aiming for a VBAC) it was sort of a dream come true.

Personally, I would describe my freebirth as “better than anything I could have dreamed up.” Though I had a moment of panic when I realized my midwives and husband were not going to make it in time to the birth (thank God I at least had my doula!), it was overall very healing to my soul in ways I could not have anticipated. Perhaps, though, I am one of those people who author Heather Baker describes as having “eleutheromania”, defined as “an intense and irresistible desire for freedom.”

The point I really want to make is that unassisted birth is a possibility for any pregnant person, whether they are planning it or not. For that reason, I believe it is important for all expecting parents to try to envision that possibility and make peace with it.

You may do that by picturing yourself or your partner calling for an ambulance full of EMTs (who are not trained birth professionals) to pick you and your newborn up to bring you to your hospital.

Or, you may do that by picturing yourself remaining in place at your home (or wherever you may be), and monitoring yourself and your baby for good recovery as you enjoy your own environment. If you choose the latter, this book will be a wonderful resource!

Be warned, however, that you may just decide after reading this book that you like the idea of a planned unassisted birth! In that case, this book will be a necessity to keep handy.

Table of Contents

I’m copying the table of contents below so you can get an overview of what to expect in Home Birth on Your Own Terms:

• Dedication
• Introduction
• Getting Pregnant
• Already Pregnant
• Prenatal Care
• Self, Home Prenatal Care
• Common Discomforts in Pregnancy
• Preparation for Birth
• Birth Plans
• Birth Affirmations
• Labor
• Types of Labor
• Pain Management in Labor
• Positions in Labor
• Stages of Labor
• Your Baby is Here!
• The 1st Hour After You Give Birth
• Your Baby in the 1st Hour
• Placenta Delivery
• 4th Trimester for the Mother
• Your Baby in the 4th Trimester
• Postpartum Birth Matters
• Placenta Consumption
• Herbs
• Homeopathics
• Essential Oils
• Complications in Pregnancy
• Issues/Complications in Labor
• How to Perform CPR on a Newborn
• Postpartum Complications/Emergencies
• Resources
• Birth Stories
  • Edna’s Breech Birth
  • Undisturbed Instinct
  • The Twin Birth of Aoife and Saoirsee
  • 2 Unassisted Births
  • The Freebirth of Archer Wild
  • Birth Story of Olive Paisley
  • A Nuchal Hand
  • A Healing Birth
  • An Undisturbed Birth
  • An Unexpected Breech
  • VBAC
  • The Birth of Waverly
  • Our Perfect Unassisted Birth
  • A Family Birth
  • Freebirth Story of Maria Faith
• After Thoughts for Parents
• Closing Remarks

General Observations

Heather Baker, a traditional midwife, has a fairly straightforward writing style and has organized the contents of the book in an easy to navigate manner. She addresses almost any concern — the minor discomforts, the emotional roller coasters, and the serious emergencies — with useful advice. She normalizes all the experiences of pregnancy, the many variations of labor, and unassisted childbirth in the most encouraging tone. I got the sense she would be the loveliest provider to hire for a birth if I were pregnant in her neighborhood.

The book combines very useful information and advice with a chunk in the back dedicated to a diverse mix of unassisted home birth stories, all of which are encouraging in their own way and can open your mind to nearly all possibilities. This makes the title both a good reference to hold on to for various situations that may arise in your childbearing journey, as well as a good inspiration book to read cover to cover as you plan your journey.

Since the book is mostly focused on birthing at home without medical providers, my expectation was that it would include clues you need to recognize when a hospital transfer is necessary, as well as reliable solutions you can use at home to facilitate labor progress and comfort, to save your baby if he or she isn’t breathing immediately after birth, and to do basic postpartum care like cutting the cord. I would say these expectations were exceeded!

What I Loved

There is so much to love in this book! Here are some quotes I particularly enjoyed:

Birth is like peeling away all your layers. You need to let go of every past trauma and inhibition. You need to let your body take over and just be. In doing so, you are transitioning into something else… which can be a bit scary or amazing for others to witness.”

To all of those words, I would like to add AMEN. As far as letting go of every past trauma (especially prior birth trauma and sexual trauma), I can not reiterate how hugely helpful therapy can be before you go into birth. Please take note if you’re a survivor of sexual trauma that the sensations of labor can be triggering even if it has been many years since your incident(s) and even if you aren’t diagnosed with PTSD. EMDR, which is not mentioned in this book, is an especially effective therapy for just about any psychological trauma, and I can not recommend it enough!

… later [contractions] are like a charley horse in you abdomen.”

That characterization made me laugh out loud!

The contractions also stimulate surfactant in the baby to mature the lungs, it stimulates milk production to start in the mom….”

How perfectly designed are our wombs that the challenges of labor prepare our babies for healthy life on the other side!

So, you have a contracting mom who weighs about 40 lbs more than her norm, the strength of the contraction is approximately 65 lbs of weight in her uterus and you put her in a pool of water that makes her feel light. She then feels the contractions less, sometimes so faint that she things she’s no longer contracting.”

What a powerful explanation of why laboring the water is so helpful! It makes me appreciate my 3 AquaDoula birth pools all the more!

A river cuts through rock, not because of its power, but because of its persistence.”

What a beautiful image to cling to as an affirmation of your progress during labor!

Birth is about much more than the wriggling of a tiny body out of a larger one. When we birth, we don’t just birth babies. We birth ourselves, we birth our families and we reshape our lives.”

-Dr. Sarah Wickham, who I may now be quoting all over my website

The most perfect, unbearably painful, profoundly healing experience of my life.”

-Elena, a mom whose thoughts were shared in Baker’s book

I just want to hug Elena after reading her description of freebirth. I adore her even though we’ve never met.

The things I love the most about this book are how Heather Baker trusts women and promotes self responsibility and freedom. She enables good decision making and freedom by sharing her valuable midwifery wisdom and presenting options you maybe would never have known about or considered. This is so important because no matter what kind of childbirth journey you have, you can not consent to care without being truly informed, and you can best care for yourself and your newborn when you are informed. Take Baker’s information and treasure it! Take her charge to self responsibility as an honor by caring for yourself well, because ultimately, none of us can 100% depend on a medical system to take care of our needs.

One of the ways Baker encourage self responsibility is with diet, and I could not agree with her more on this. The reasoning goes beyond preventing health problems for yourself during childbearing. You are actually training your child in so much before he or she is even born, and a healthy diet and metabolism are absolutely things you teach your baby in utero. Trust me on this — it is not quite as easy to force your baby to choose a healthy diet once they are out of the womb and weaning onto solids. Why is childhood obesity becoming an epidemic in our country? Evidence points towards the metabolism and health or lack thereof of the pregnant mothers. Anyway… off of my soap box. Baker offers details on a couple of highly recommended diets for pregnancy and then sprinkles in her own advice too. The general takeaway is to have a protein rich diet full of diverse fresh, whole (minimally processed) ingredients. She also has excellent recommendations for prenatal vitamins and supplements, although I don’t agree with her assertion that you can’t get all the nutrients you need from diet (and sunshine) alone.

One of the other things I really enjoyed was the author’s list of supplies you need for a freebirth at home. A few of the things I learned I would definitely have on hand are a newborn ambu bag to safely resuscitate the baby in an emergency, wormstringe tincture for any hemorrhage, and properly sterilized, new scissors, to use after tying off the cord with either a proper cord clamp or a properly made homemade tie.

She also highly recommended a birth stool if you have access to one. Since my second child was born on a birth stool, I understood her accolades for the birth stool: “… go for it. They are really great for pushing or even the end of transition when you need to be in a position that allows dilation to happen quickly and you feel best on the toilet but are afraid to birth on it. The birth stool has an open font so you have easy access to catch the baby.” I think they are pretty great, and actually bought one for my doula practice earlier this year. Feel free to reach out to me if you’d like to rent it for your upcoming birth!

Since my review here is lengthy enough, I’m going to spare you all that I thought was excellent, but know that details for prenatal care and testing as well as management of dangerous scenarios (prior to EMS arriving or to your partner driving you to the hospital) are definitely well explained.

My last note here will be on Baker’s recommendations for common discomforts and position changes. She truly had great advice! I just want to list some additional recommendations I feel she missed. For various discomforts: nature therapy (“forest bathing”), acupuncture, craniosacral therapy, energy kinesiology, and prenatal massage. I’m happy to offer local referrals for each these to any of my clients. For position changes, you may want to consider looking into the Miles Circuit (during labor) and Spinning Babies (prenatally and in labor). These are not necessary, especially if you feel strong instincts telling you what positions you should try. However, many of us benefit from a guide to help us move effectively through labor, and these resources provide more specific help with positioning than Baker’s more general suggestions.

My Critiques

I do not enjoy giving negative feedback on what I consider to be truly noble work with mostly wonderful suggestions, but to give a completely honest review of this book, I have to admit that I was irked over and over by the poor grammar and occasionally questionable advice I found in Home Birth On Your Own Terms.

If you want a midwife writing to you as if y’all were having a conversation together in person, you probably will not care as much about the grammatical errors — most of which were sentence fragments. Personally, I view improper grammar in a reference book as an indicator of lack of professionalism and a red flag that perhaps the author is not detail oriented in other ways that are perhaps more important. However, I am also a recovering perfectionist, so I have tendencies to be overly critical of things that are insignificant.

There were several sections of the book that introduced material to me that I am not qualified to critique, so I want to disclose that. Keep in mind that I am not a medical practitioner, an herbalist, or a certified aromatherapist.

That said, I appreciate that she included a lot of recommendations for nonprescription solutions such as herbs, essential oils, and homeopathy, because having options is always liberating for a pregnant or birthing person. However, you may just want to consider doing your own research to gain more confidence before using some of her advice. I know I personally want to research superglue in lieu of stitches before I ever try that trick in my house!

You may also want to do your own research on some of the diet advice. Although the author endorses what seems to be a high sodium diet for moms with pre-eclampsia, it seems there is conflicting advice on this when you seek other professionals’ opinions. Sprouts, recommended in this book, have appeared on some of the “do not eat” lists for pregnant women due to risk of bacterial infection. Perhaps they should only be consumed if they are very fresh and sourced carefully (or spouted at home). Same goes for sushi. Another recommendation was raw milk. For all of its benefits, raw milk unfortunately spoils more quickly than pasteurized varieties and may be more likely to have concerning contaminants, too. I personally enjoyed raw milk from a farmer who lived near me in Virginia, but I was able to visit the cows in person and see their equipment at will, and I got a fresh resupply weekly. When moving to Florida, I signed up for a raw milk service only to abandon it later for pasteurized goat milk from the grocery store, because my dairy farmer here lacked the same accountability and only delivered every other week. If you have a better source here than I did, you may feel safe to drink raw milk throughout pregnancy as long as you accept that there are certain risks.

I also feel a little concerned about the author’s confident assertion that the American College of Obstetricians and Gynecologists (ACOG) supports waiting until 43 weeks to induce labor. This would be a nice statement to have supported with a citation to one of ACOG’s committee opinions or practice guidelines, but Baker unfortunately does not include citations in her book. Perhaps there was a time in the past when ACOG would have agreed with Baker, but my understanding from working as a doula is that OBGYNs today are rarely comfortable with the risks of a patient exceeding 42 weeks without induction, regardless of the results from their non stress test, biophysical profile, and electronic fetal monitoring. Most medical teams locally seem to prefer induction at 41 weeks. I honestly do not even know if local hospitals will support doctors’ privileges if their patients opt to decline induction at 42 weeks. I’m sad to say you may need to do your own research before repeating Heather Baker on this topic.

She also dismisses the possibility of a cesarean scar rupture during home VBAC (vaginal birth after cesarean), attributing ruptures exclusively to hospital inductions and Pitocin. Since I was witness to the beginnings of a scar rupture in a spontaneous, unmedicated TOLAC (trial of labor after cesarean), I know for certain that Baker may be misguiding her readers with that comment. Her words may be true in most cases, but do know that home birth alone may not prevent the rupture of a cesarean scar. For anyone reading this who has concerns of birthing after a cesarean, you may be able to take heart in knowing that the case I witnessed was for a pregnancy that was very close in spacing to the previous one, and that generally, having at least a year to recover from your cesarean before conceiving again will help prevent scar ruptures. To Baker’s credit, she likewise recommends spacing your babies out after cesareans to promote healing.

If after your birth you develop mastitis (a breast infection), be warned that the Academy of Breastfeeding Medicine’s most updated recommendations (2022) for managing mastitis do not align with Heather Baker’s advice to massage and pump the breast frequently. What you need to know if you have mastitis is that you can actually make your situation worse with pumping and with improper massage. Pumping cues your body to make more milk, and mastitis occurs when you already have an oversupply of milk. Absolutely keep feeding your baby, on demand if at all possible, but if you’re having mastitis, you may want to skip the pump and seek the advice of a breastfeeding professional such as an IBCLC.

Lastly, I believe the idea of having a doula attend your birth is undersold in this book.

Heather Baker mentions some doulas are prohibited from attending unassisted childbirths by their certifying bodies, which I can not vouch for. I do know that DONA International, the largest doula training and certifying organization and the one with which I am personally affiliated, does not have a policy prohibiting my attendance at freebirths. What is worse is that Baker goes so far as to suggest that some doulas might call the police or child protective services on you for your plans to birth without a medical provider! I find that incredibly appalling. There are certainly some doulas who do not feel comfortable with attending a free birth — and those are not the ones you want to hire in this case — but that does not mean that they would call authorities on you when you suggest you’re planning a free birth. If it has happened before, I feel terrible for those parents. To be safe, you could take a neutral stance when interviewing doulas, and just casually ask, “What are your thoughts on free birth?” If you get a negative reaction and suspicions are raised against you, perhaps just mention you’ve head of some free birth stories and merely were curious for different points of view. Then you can detach (as you should for anyone who disrespects your birth plans) and move on to other doulas, trusting we are not all that way!

I mainly get the impression that Heather Baker undersells doulas because she is trying to be sensitive to the financial needs of readers who prefer DIY solutions. Other suggestions throughout the book (inflatable kiddie pools, self prenatal care, and using superglue instead of stitches for perineal tears) support this notion. Skipping a doula may of course save you money. However, the reverse can also be true, which is why insurance companies (at least medicaid and tri-care) are increasingly paying for doulas. The evidence is overwhelmingly in favor of doulas for parents who want a natural birth, which saves money over a birth with medications and other interventions. This can be especially true for first time parents and parents attempting a VBAC. Of course, only if it is the mom’s desire to have a doula should she have one, but costs should not be a limiting factor. I choose to believe that frugal parents who are reluctant to share their freebirth plans with family and friends could at least share that they would like a doula, and ask for monetary gifts that could pay for a doula’s services in lieu of traditional baby shower gifts (many of which are truly unnecessary anyway or which can be purchased in “used – like new” condition for a fraction of the cost through online marketplaces and consignment shops).

My Overall Opinion

On a 5 star rating scale, I would award this book 4 stars. The deduction of a star is primarily over what I consider to be poor editing and lack of citations to any scholarly evidence. I’m sure many other readers are less picky than I am about these details, and will give Baker benefit of the doubt since she is an experienced traditional midwife whose clients have mostly fared well, as far as we can tell.

Home Birth On Your Own Terms probably is not worth reading for many of my clients who know that the hospital is where they feel safest. The main exception would be for a parent who is extra curious about what their midwife or doctor would be looking for throughout pregnancy and birth. The book would also be especially useful for a mom who prefers to do self assessments of cervical dilation in labor, and decline vaginal exams from hospital staff.

For parents who are openminded about a home birth — whether unassisted or assisted with midwives — I believe this book is a true asset. Since medical providers are not at your home 24/7 as they are in a hospital, by default you have a greater chance of having an accidental freebirth when you are planning a midwife assisted home birth. Typically these accidents are pretty safe, since swiftly descending babies do not have complications to hold them back from being born, however, it may provide peace of mind to have the extra knowledge offered by this book.

I really appreciate the depth of knowledge Heather Baker shares, which can be impossible to find in a childbirth class or other pregnancy and birth books. Remember: most childbirth classes and other birth books presume you will have a licensed medical provider in attendance. By lifting the veil away from the clinical care details usually reserved for the medical team, Baker emboldens parents so they truly can have home birth (or natural birth in any location) on their own terms.