Pregnant woman in front of a birthing pool.

By eyeliam on Flickr \ CC BY 2.0

Pregnant people spend a lot of time answering questions. What will you name the baby? Are you going to breastfeed? What kind of diapers are you using? Have you finished the baby’s room? Did you do prenatal classes? Some parents-to-be feel like they spend half their time answering personal questions – and the other half fending off friendly hands looking to give an affectionately intrusive pat to their growing bellies!

But one question that rarely gets asked is this: where are you going to have the baby?

Most Canadians assume that their babies will be born in a hospital, but more and more are being born at home or in out-of-hospital birth centres. There are many factors that lead prospective parents to choose home birth – some worry about infection rates in the hospital and others feel that they have a greater degree of autonomy in their own space, while many simply feel that their home is the most comfortable place to be. And, for those who are environmentally-conscious, sustainability may be part of the decision-making. The environmental impact of healthcare choices is infrequently considered, and the extent to which it is factored into institutional decision-making varies widely by hospital. Many facilities have made sustainability a priority, like the Sunnybrook Health Sciences Centre in Toronto, which recently adopted “Bulb Eater” technology in order to sustainably recycle fluorescent light bulbs on-site. On the other end of the spectrum, many institutions have pushed greening their facilities down to the bottom of an ever-expanding to-do list; there are more than a few hospitals across the country which still have no cohesive recycling program in place.

Birth is one healthcare-related moment in the lives of many families when choice is not only possible but encouraged.

For many users of hospital services, shopping around for a green facility simply isn’t practical or realistic: if you are sick, you have to go where the doctors are, and the presence or absence of biodegradable containers in the cafeteria is unlikely to be the first thing that occurs to you when the ambulance arrives. But birth is one healthcare-related moment in the lives of many families when choice is not only possible but encouraged.

In provinces where legislated midwifery is well-integrated into the healthcare system, midwife-attended home birth is safer overall than hospital birth, and it is considerably gentler on the environment. Home birth reduces consumption not only of supplies such as towels (which go into the laundry at home but are often disposable in the hospital) but of packaging. Midwives sterilize and package their own instruments in the clinic, eliminating the use of environmentally-costly “delivery packs,” which account for a significant slice of packaging waste in hospital births, a recent study found. Home births also lack the institutional HVAC and energy costs of hospitals, as you might expect.

In contrast, a home birth usually requires only an extra load of laundry and a kitchen garbage bag full of waste over and above normal household output. Home births are also less likely to result in Caesarean section, the most resource-costly mode of birth, than equally low-risk and normal births taking place in the hospital.

Of course, midwife-attended home birth is an option only for low-risk pregnant people. That means a healthy pregnancy for people expecting a single head-down baby. And sometimes planned home births end up in the hospital for a variety of reasons, pain relief being the most common and emergencies being the least. But for those who have the option, home birth can be a safe and empowering way to reduce your environmental impact while growing your family.

Liz Fraser is a midwife with a background in feminist bioethics and philosophy of medicine. Besides catching babies, she enjoys collecting shells, starting (but not finishing) craft projects, and arguing with her cat.

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