The day your baby is born is hands-down one of the most important of your life. You’ll of course give major thought to everything that happens that day, from who’s in the room to where you deliver—in a hospital or at home. The American Academy of Pediatrics (AAP) recently published a policy statement with guidelines for the care of infants in home births.
Planned home births are uncommon—they comprise less than one percent of all births in the United States—but the amount of women choosing them has grown in recent years. In 2011, the American College of Obstetricians and Gynecologists (ACOG) released a committee opinion saying that while they believe that the safest place for a baby to be born is in a hospital or birthing center, they respect whatever medically informed decision a woman makes about where she gives birth. And the AAP echoes that ACOG opinion in their new statement. “Based on current evidence, we think that hospitals and birthing centers are safest for baby for being born,” explains Kristi Watterberg, MD, the lead author of the statement and a neonatologist and professor of pediatrics at the University of New Mexico. “But we recognize the right of the mom to make that choice. There are lots of reasons people might want to have a home birth, and those have validity, as well.”
In the AAP statement, the authors outline planned home birth recommendations for healthcare providers. These include making sure there are at least two people at the delivery—one whose main responsibility is caring for the baby and who has the skills and training to resuscitate the baby if that becomes necessary—and making sure that the phone is working and an arrangement has been made with a nearby hospital in case there’s an emergency. Many things must also be done for the baby once he or she is born, such as a detailed physical exam, several screenings, and Vitamin K injection. The AAP also agrees with ACOG when they say that moms should choose a midwife only from those who are certified by the American Midwifery Certification Board. Find the complete list of recommendations here.
Trying to figure out what the best plan is for you and your family? Watterberg advises all first-time moms (even ones who have already decided) to schedule a prenatal visit with their anticipated maternity care providers. “I think it’s really important to talk to your obstetrician, midwife, pediatrician about what you would like, why you would like it, and what your concerns are,” says Watterberg. Ask about the risks and benefits, in their view, of their approach.
And if you are thinking about giving birth at home, discuss whether or not you’re a good candidate with your healthcare provider. That includes being at term, not having any pre-existing medical conditions that put you at higher risk (like diabetes or high blood pressure), and having a baby that’s in vertex position (not breech) and not too big or too small. “You should have all of those things that make what would look to be a normal, happy, healthy delivery for both mom and baby before you decide to try an at home delivery,” says Watterberg.
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