Is homebirth safe?
Safety has been held up as the reason why all women should give birth in the hospital. This is despite the fact that no data support the contention that homebirth holds any excess risk provided:
- the mother is low risk
- the homebirth is planned
- she has a trained, experienced birth attendant
- there is a modern hospital within a reasonable distance
When would a homebirth be inadvisable?
- When there are risk factors. Homebirth practitioners agree that some risk factors should rule out home birth. The mother having high blood pressure, or the baby coming early would be two of those factors, while they disagree on others such as the mother having a prior cesarean. In the end, it comes down to you making an informed decision based on the balance between the risks you run at home versus the risks you run in the hospital. To make this assessment, you must weigh your particular circumstances and the skills and experience of the homebirth practitioner against the local hospital care available to you.
- When no trained, experienced homebirth attendant is available. Most of the emergencies that arise without warning at a low-risk birth -- the baby's shoulders are stuck (shoulder dystocia); the baby doesn’t breathe; heavy bleeding -- can be resolved or stabilized for hospital transport by a skilled pair of hands and readily portable medication and equipment.
- If you think you will probably want pain medication. You may also feel hesitant or uncomfortable about having a homebirth. No matter what your intellect says, if your gut says “I shouldn’t be at home,” labor may progress poorly. If you plan a home birth, you must be well prepared and confident of your ability to cope with the pain of labor. A difficult labor may eventually lead to transfer into the hospital for, among other things, pain medication, but you shouldn’t start off indecisive about using it.