AAP Issues Recommendations For At-Home Births
April 29, 2013

AAP Issues Recommendations For At-Home Births

Brett Smith for redOrbit.com — Your Universe Online

While still less than one percent, the number of mothers deciding to give birth at home is on the rise, according to the American Academy of Pediatrics.

In light of this trend, the organization has released a policy statement and series of recommendations on giving birth at home.

"Babies deserve the best care they can get," the statement´s lead author Dr. Kristi Watterberg told HealthDay. "And we need to support women wherever they choose to give birth.

"It's important to remember that this is an area of strong emotion,” she added. “You'll see babies in home births have terrible things happen, but you also have terrible things happen in the hospital sometimes. Women have the right to make an informed decision.”

The AAP statement recommended the mother´s health presents a low risk during a home birth; specifically that she doesn´t have any preexisting conditions and is disease-free. The statement also advises the mother have only a single pregnancy and the baby´s head is facing down.

The organization also had advice for pediatricians who have a patient planning to give birth at home, telling them to warn expecting parents ten to 40 percent of women may require hospital care due to unanticipated complications.

Before the expected due date, all medical equipment and phones should be tested and the weather should be monitored, the statement said.

During the actual birth, the AAP recommends at least two people are present, including a certified physician or nurse-midwife trained in the resuscitation of an infant should the need arise.

Once the baby is born, his or her care should adhere to standard hospital practices, including providing warmth, a physical examination, screening for infectious diseases, necessary vaccines and encouraging breast-feeding.

“A woman planning a home birth has a lot of due diligence to take care of that she doesn't have to worry about in the hospital, like making sure the correct equipment is there, that the staffing is there and qualified,” Dr. Peter Bernstein, a director of the perinatal safety program at Montefiore Medical Center in New York City, told HealthDay.

"I understand where women are coming from,” he added. “A hospital birth can become very medicalized and women feel a loss of control, but I'm nervous about home births.

“Too many simple things can turn into disasters at home,” Bernstein said. “Even in low-risk women, things can go wrong. Then you may be 20 minutes from the hospital, and it's another 15 minutes once you get to the hospital before you can get the baby out in an emergency.”

Despite warnings like these from highly qualified medical officials, a recent report from the Centers for Disease Control and Prevention found the number of home births increased 20 percent between 2004 and 2008. Besides the various medical hurdles, many state laws and regulations make a home birth difficult to achieve.

The policy statement and recommendations are available online and will appear in the May issue of the journal Pediatrics.