Home Birth

Home birth in Western countries remains an issue of lively debate. In the United States, the official position of the American College of Obstetricians and Gynecologists is that deliveries should take place in hospitals. This differs from the position of the College of Nurse Midwives who support Home Birth “for low-risk pregnancies”.

In Britain, as recently as the beginning of the 1960s, over a third of all women had their babies delivered at home. This rate has steadily fallen to about 1 in 50 today (2%). What may surprise many further is the fact that in neighbouring Holland, the rate today is around 32% (sounds familiar?). In Denmark, 4 out of every 5 pregnant women have their babies away from hospitals, either at home or in centers run by midwives. And yes, the rate of perinatal complications is comparable.

There has always been a significant demand for this option and its availability (or lack of) is a real issue, to varying degrees, in various countries or even various parts of the same country.

Why a Home Birth:

One area where there is almost total consensus is the fact that childbirth is a natural process. There is also an acknowledgement on the part of the medical profession that, in some parts of the western world at least, this process may have been over-medicalised. Many women realise that the experience of childbirth might be more profound and fulfilling if achieved in their own home environment with the participation, in one way or another of other members of the family, including the older siblings of the newborn.

Observational studies point to an overwhelmingly positive experience for those who manage to achieve a planned home birth with enhanced satisfaction, self-esteem, sense of control and empowerment.

What is Required for a successful Home Birth

For those who desire a home birth, it is important to have a grip of all the requirements that need to be in place to ensure a successful outcome. Safety of both mother and baby is the absolute pre-requisite for this strategy. Desiring home birth in itself isn’t sufficient. This may sound obvious but there are a number of people who fail to fully appreciate this. There has got to be a robust organisational framework allowing this to work without hiccups.

Home Birth requires a multi-disciplinary approach with the midwife who is to assist in the birth at the centre of this. It is an accepted wisdom that home birth is only suited to low-risk pregnancy. A robust risk-assessment needs to be carried out and this is a continuing process until the onset of labor. If, for instance, a woman who is planning a home delivery and is assessed to be low-risk goes into labor prematurely, that instantly ceases to be low-risk and the plan should be abandoned.

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The attraction of a Home Birth lies partly in the fact that this will take place in the woman’s own environment with those closest to her sharing in the experience