In Home Birth Interest Rises During Pandemic
Given the increasing interest in home births, the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) recently released statements claiming that hospitals and certified birthing centers are the safest places to have a baby.
The AAP also published safety guidelines for those planning to give birth at home, along with who is considered to be a good candidate for an in-home birth.
Low-risk pregnancies are candidates for home births
Most health experts agree that people who want to give birth at home should have a low-risk pregnancy.
A 2019 review of research has shown that low-risk pregnant women aren’t any more likely to develop complications at home than they are at a hospital. In fact, home births are generally associated with lower rates of maternal interventions, such as inductions of labor, cesarean sections, and major perineal tears.
The AAP also recommends that pregnant women giving birth at home should be at least 37 weeks pregnant (less than 37 weeks’ gestation is considered premature) and that each woman has a healthcare team of at least two people — one of whom must be responsible for the health of the newborn.
Additionally, women who are considered to have a higher risk pregnancy — such as those with diabetes, preeclampsia, a previous Cesarean section, or carrying multiple fetuses — should consider giving birth in a healthcare setting, as they may develop life-threatening complications.
Talk to your birth specialists and understand what medications and equipment they’ll have available, along with their background and skills.
If you decide to move forward with an in-home birth, health experts recommend having a plan in place in case you need to be transported to the hospital.
The vast majority of low-risk pregnancies will have positive outcomes at home, according to a 2015 cohort study that analyzed more than 800,000 births.
That said, some women may experience unanticipated complications — such as postpartum hemorrhage or a sudden drop in the baby’s heart rate or oxygen levels — that could require transport to a hospital.
According to a 2014 study published by The Midwives Alliance of North America that examined the results of almost 17,000 home births, approximately 11 percent of laboring mothers were transferred to the hospital. Most of these cases were transferred not because of emergencies, but because labor was not progressing.
Home births are even safer for those who have previously given birth. According to ACOG, about 4 to 9 percent of pregnant women who’ve previously given birth will need to move to the hospital. This number is a decrease from the 23 to 37 percent of first-time moms who need intrapartum transfer to a hospital.
Still, in coronavirus “hotspot” areas, emergency services may be delayed. Also, the AAP suggests that giving birth close to a hospital is key in the event a complication occurs; having to travel more than 15 to 20 minutes to a medical facility has been associated with adverse outcomes for baby, including death.
One of the main reasons pregnant women are considering home births is due to the fear of contracting COVID-19 in a hospital.
Additionally, most staff members wear N95 masks, eye shields, gowns, and gloves if and when they expect a patient to have the coronavirus, Illuzzi said, adding that surfaces are cleaned and disinfected routinely to prevent infection.
If you’re interested in giving birth at home, talk to your doctor or midwife, and share your thoughts and concerns with them.
They’ll be able to evaluate both the maternal and fetal health of your pregnancy and identify any risks you should be aware of.