Home births in this day and age? I don't think so-Ask Dr. Paul Library

DEAR DR.PAUL: What do you think of natural home births? A few of our friends have suggested this to us as being natural way of giving birth. I am expecting a new baby in 6 months, what do you think?

PEDIATRICIAN DR.PAUL Answers: Thank you for this question as it brings up several important issues. The first and foremost is the concept that home births are natural, and the mistaken interpretation that natural always implies safe. For example, in the pre-antibiotic/hospital era when children were born at home, the perinatal(newborn) infant death rate was quite high, not to mention maternal death rates as well.

With the advent of hospitals, our understanding of how to combat and/or prevent the possible complications with the necessary equipment and specialized trained people, the rate of complications to baby and mothers has decreased. In my mind, giving bitrh at home, in the absence of the necessary expertise, surroundings, equipment and personnel is going backwards.

Most deliveries are thankfully uneventful, but there are those that go wrong and personally I would rather it go wrong in a setting where all the necessary resources are readily and immediately accessible. Babies that are sick or in trouble when born need immediate attention. Something that cannot be fully offered in the home setting.

On the other hand, I agree that changes need to be made in the way maternity wards and case rooms are set up. Hospital maternity wards and case rooms have responded to this need by adapting to today's family needs and offering very nice family room settings for childbirth where the whole family can attend and share the joy of birth of a loved one. These rooms have all the necessary equipment and offer the trained personnel that can attend to problems immediately. In many regions,  there are birthing centres set up as well that provide midwife care which are equipped for any urgent situation or complication. that offer another place for a baby to be born around his/her family.

If, as in most cases, the birth is uncomplicated, the equipment and available resources are not used. However, in case where it is needed it is nice to know that it is there. Please do not get me wrong ... most deliveries occur normally without any problems. However, as a pediatrician who has attended deliveries that have gone wrong, I understand that the right care immediately can make all the difference. So why not have all the chances on the baby's side?

The bottom line is that I do not feel that it is right nor safe to voluntarily deliver a baby at home, given that hospitals/or approved birthing centres with appropriately staffed/equipped birthing rooms exist and offer a truly safer alternative both for mom and new baby.

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