Homebirth: Making an Informed Decision to Birth at Home
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The hospital will also have a pediatrician or pediatric team present at the birth as an added precaution. The most common reason for hospital transfers in women who are having their first birth is slow or stalled progress during labor. This might occur during any stage of the labor process from early, active, to pushing.
A systematic review will be useful for women in making informed choices, and for the planning of care for these women. In Sweden, homebirths are rare -- as rare as in the US -- that is, less than 0.1%. In Lindgren, et al.'s study , the homebirth transfer rate was 25% for first-time mothers -- that is, one in four women that plan a homebirth end up in the hospital (much better than the 40% rate in the Netherlands). The most common reasons women transfer to the hospital are "lack of progress" and the midwife being unavailable for the mother during labor. A certified nurse midwife has at least eight years of education to provide safe care during home births. Although birthing is a natural process, there are many ways to ensure the experience is healthy.
High blood pressure during home birth
Between 1.7% and 7.3% of women and neonates were transferred to hospital after birth. Four studies provided analyses stratified for parity; between 1.6% and 8.9% of nulliparous women and between 1.6% and 5.5% of the multiparous women were transferred after birth. Nine of the 15 included studies described the time span for transfers after birth, and this time varied from 2 hours to 5 days. The 15 studies included a total of 215,257 women with a planned home birth upon onset of labour.
Plus, she stresses the likelihood of a cesarean section is much higher if a woman begins labor in the hospital. Currently about 30 percent of hospital deliveries are done by a C-section in the U.S. . That rate is much higher than the World Health Organization's recommended 10 to 15 percent. For a home birth perspective, I talked to Maria Iorillo, a state-licensed midwife in San Francisco. She's attended births for three decades and says she's tallied 1,400 births, most of which unfolded safely at home.
Births in the U.S.
Midwives also work collaboratively with other health professionals to ensure your needs are met. This may be obstetricians, physiotherapists, chiropractors, acupuncturists, naturopaths, nutritionists, sonographers and many more. A primary facility is one that does not have inpatient secondary maternity services, or 24-hour on-site availability of specialist obstetricians, paediatricians and anaesthetists. Here you will still have your LMC present and involved in your birth, supported by other onsite midwives.
This is your home away from home option, and includes birthing units. Parents who choose a home birth must engage in a much higher level of preparation, responsibility, and involvement in the birth. Many parents cannot or should not take on this responsibility. Women who choose a home birth must also be willing to labor without an epidural, although it is possible to change your mind during labor and transfer to the hospital for an epidural.
Severe tearing after birth
She transferred to hospital for observation because of heavy bleeding afterwards. Diana planned a home birth for her first baby, but developed symptoms of pre-eclampsia and was hospitalised for twelve days at the end of her pregnancy, undergoing five doses of Prostin in an attempt to induce her labour. When all that was unsuccessful, Diana agreed to an elective caesarean. This story was written 11 days after baby Maia was born, and Diana was still having difficulty coming to terms with what had happened, so be prepared for some raw, but honest, feelings. Peta transferred to hospital after the birth because of concerns about her baby's breathing.
Most women planning a homebirth have done a good deal of research and have weighed the risks and benefits of each choice. Research has consistently shown that low-risk women in the US who chose home or birth center birth have lower rates of intervention when compared to those who chose hospital birth. Besides homebirths being more satisfying for women , one of the main reasons some women choose a planned homebirth over a hospital-based delivery is because both mothers and babies have better outcomes.
Figures from The Ministry of Health’s Report on Maternity in 2010 show:
This score is used in studies comparing home births vs. hospital births. Some studies have found a greater number of low Apgar scores measured at five minutes in at-home births (without also considering the mother's risk factors). Most transfers to hospital occurred during labour and before the birth of the neonate. Across the 15 included studies, 8.2% to 24.1% were transferred. Seven studies that performed analyses stratified for nulli-and multiparity reported that 22.5% to 56.3% of all nulliparous women were transferred.
This page provides some factual information and testimony to help families make informed choices about how and where they birth. Throughout this section you will find links to more detailed resources on the home birth choice. The birth provider should help determine who is low-risk and a good candidate for homebirth. A more recent study Planned Out-of-Hospital Birth and Birth Outcomes published in 2015 reported a 16.5% transfer rate, with only 4% (which is 0.66% overall) being considered emergent.
At hospital she was told that she could not have an epidural as her labour was too advanced, and she had an horrific forceps delivery. Inger is from Holland where homebirth is common, and she planned a homebirth for her first baby. It was not to be, though; although prelabour started at home, she developed pre-eclampsia and transferred to hospital for induction. Baby Nathan was back-to-back and was turned by forceps after a tough labour, but Inger still managed to push him out herself.
Black communities, which are disproportionately affected by COVID-19, are often left behind when it comes to adequate medical care, in general. In fact, in the U.S., pregnancy-related deaths , affect Black women three times as often as White women. These might include bed rest during labor, frequent electronic fetal monitoring, limited oral intake, more frequent vaginal exams, induction, "breaking the water" intentionally, and insertion of a catheter.
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