Lately, the topic of home births is becoming more and more common.
Especially this topic has become popular in the last few years.
How do you personally feel about this idea?
Perhaps you have such experience in the past?
Perhaps you have acquaintances who have given birth at home? Who did they invite to deliver their babies - a nurse-midwife or an obstetrician-gynecologist?
I don't mean those cases when because of a quick labor (didn't have time to drive) the baby was accidentally born at home. I mean those births when everything is planned in advance and the birth is carried out at home.
In 2018 in Ukraine, about 139 women gave birth at home by their own choice. The statistics of complications of this number of births are not known.
Only statistics in the UK and America are known. Let me give an example of America.
In 2017, 62,228 births took place at home - that's 1.61% of all births in America. For every 1 home birth there were 62 hospital births.
Of course these are all low-risk pregnant women. The birth is delivered by a qualified Midwife who has a connection to the birthing center and is legally responsible.
Below is a list of what low risk pregnant women are at risk of complications.
✔️Отсутствие medical conditions
✔️Отсутствие pregnancy complications
✔️Один fetus
✔️Головное pre-pregnancy
✔️Роды at 37-41 weeks gestation
✔️Отсутствие history of cesarean section.
If you look at the statistics, fewer births in this group ended in a CS compared to those who gave birth in the hospital. But this is not surprising, because the group is represented by women with only low risk of complications. Women also reported a positive emotional state from being in familiar surroundings.
Now let's look at another statistic.
Neurologic complications in newborns were reported at a ratio of 2.2 vs. 0.86 (home conditions vs. hospital conditions); fetal death in labor 3.9 vs. 1.8, respectively. I would like to emphasize that this is not an absolute number, but a ratio of cases. That is, neurological complications and neonatal deaths during home delivery exceeded those in hospital conditions by 4 times! And this is in cases of delivery of low-risk pregnant women!
And what to speak about our (post-Soviet) conditions!
But in spite of this, new-fangled doulas and retired midwives are increasingly broadcasting on screens and in the press with angelic faces and voices about how wonderful it is to give birth at home. They say that in hospitals doctors treat women in labor harshly, that many unnecessary interventions and procedures are done, and that they, these angels, will give the family the opportunity to feel the unity of the family and the power of natural childbirth!
Sounds like fun! Who wouldn't want such a heavenly paradise?
Now let's take a look at what it used to be like to have a natural childbirth.
Before the revolution, 1 in 7 women died from complications during and after childbirth! These included hemorrhage, uterine rupture, and sepsis. Remember the expression "postpartum fever" from the movies? That's about sepsis, which without antibiotics is doomed to be fatal. Antibiotics were not invented until 1945. They were! The number of non-fatal complications is almost one in three - anemia, uterine prolapse, urinary incontinence, bladder fistula, etc. The statistics of newborn deaths at the time were simply murderous.
And so, someone wanted to give birth naturally!
The main disadvantage of home birth is that there is no constant monitoring of the fetus and no immediate response.
In England and America, where midwives are well trained, have standards and protocols, and have a link to the hospital, transportation is quick because:
a) an ambulance arrives quickly,
b) high quality roads,
c) city roads have a special line for police, fire and medical vehicles even during traffic jams,
c) the midwife has a connection with the hospital, a team is already waiting for them there, and the operating room in the hospital is set up during transportation.
But even with these super conditions and conditions of transportation, it is not possible to observe the time factor for saving the fetus. After all, in case of acute fetal distress, the doctor in the hospital has 5-20 minutes to snatch the baby (cesarean section or vacuum extraction) and provide resuscitation,
Tell me, where and in which cities do such conditions exist in Russia, Ukraine, etc.?
But even in America and the UK the statistics of complications of newborns do not sound in favor of home births.
One last thing. I also consider it unacceptable and irresponsible on the part of the future mother to risk the health and life of the child for the sake of desire to experience romantic feelings, which may turn out to be a tragedy. The child cannot protect itself and choose the conditions for childbirth. Therefore, the issue of the child's defenselessness and abusiveness is also an open question.
In all cases, in order to solve the question, we need to include logic: to assess our own capabilities, the capabilities of others, the situation we are in, possible risks and our own responsibility to the unborn baby.