scholarly journals “Home Birth” with an Obstetrician: A Series of 135 Out of Hospital Births

2015 ◽  
Vol 2 (4) ◽  
Author(s):  
Stuart J Fischbein
Keyword(s):  
Home Birth ◽  
Hospital Births

scholarly journals Notes on home birth: Safety, interventionism and satisfaction

2020 ◽  
Author(s):  
Marc Cruellas ◽  
Fina Martinez Soler ◽  
Avelina Tortosa ◽  
Pepita Gimenez-Bonafe
Keyword(s):  
Practice Guidelines ◽  
Good Practice ◽  
Home Birth ◽  
Developed Countries ◽  
Systematic Research ◽  
Maternal Outcomes ◽  
Controversial Topic ◽  
Hospital Births ◽  
Planned Home Birth ◽  
Unusual Situation

Abstract Background: Home birth is still considered an unusual situation on most developed countries, where it accounts between 0.2 and 25 percent of all births depending of the country. However, the safety of the process and whether it should be offered as a choice makes it a controversial topic with strong opinions on both sides. This review aims to describe the situation of home birth in several developed countries and debate its safety and mothers’ satisfaction, by reviewing studies that compare home vs. hospital births.Methods: A systematic research has been done using different search engines to find publications that portray the current situation on this topic. Protocols and historical facts were selected using no filters, while publications reporting maternal and birth outcomes, as well as levels of satisfaction, were selected using filters that limited the search to articles that had been published in the last 10 years. A total of 45 articles were selected and reviewed.Results: Home birth in each country depends on many factors, including historical and cultural. Some countries have either developed good practice guidelines or included home birth on the already existing ones, while some other countries still do not recognize it as a safe option. While most studies do not show significant differences on neonatal mortality APGAR score and intensive care admissions, they do describe slightly better maternal outcomes on home birth due to lower interventionism. Studies also show that between 13 and 29 percent of home births require transferring the woman or the fetus to the hospital. Satisfaction levels also appear to be higher in women who had a planned home birth.Conclusions: Home birth appears to be a safe choice for women with low risk pregnancies, due to a lower rate of interventionism. However, safety depends on many factors, from professional accreditation, to the presence of protocols and good practice guidelines. Satisfaction also appears to be higher on women who had a planned home birth, although it depends on personal considerations and circumstances.

scholarly journals Apgar Scoring System in Brazil's Live Births Records: Differences between Home and Hospital Births

2018 ◽  
Vol 41 (02) ◽  
pp. 076-083
Author(s):  
Jordana Bessa ◽  
Naieli Bonatto
Keyword(s):  
Apgar Score ◽  
Hospital Setting ◽  
Home Birth ◽  
Informed Choice ◽  
Singleton Pregnancy ◽  
Apgar Scores ◽  
Unified Health System ◽  
Preliminary Study ◽  
Hospital Births ◽  
Birth Records

Objective To promote informed choice for women and to compare home and hospital births in relation to the Apgar score. Methods Mother's profile and Apgar score of naturally born infants (without forceps assistance) in Brazil between 2011 and 2015, in both settings—hospital or home—were collected from live birth records provided by the Informatics Department of the Unified Health System (DATASUS, in the Portuguese acronym). For the analysis, were included only data from low-risk deliveries, including gestational time between 37 and 41 weeks, singleton pregnancy, at least four visits of prenatal care, infants weighing between 2,500 g, and 4,000 g, mother age between 20-40 years old, and absence of congenital anomalies. Results Home birth infants presented significantly higher risk of 0-5 Apgar scores, both in 1 minute (6.4% versus 3%, odds ratio [OR] = 2.2, confidence interval [CI] IC 2–2.4) and in 5 minutes (4.8% versus 0.4%, OR = 11.5, CI 10.5–12.7). Another finding is related to recovery estimates when from an initially bad 1-minute Apgar (< 6) to a subsequently better 5-minute Apgar (> 6). In this scenario, home infants had poorer recovery, Apgar score was persistently < 6 throughout the fifth minute in most cases (71% versus 10.7%, OR 20.4, CI 17–24.6). Conclusion The results show worse Apgar scores for babies born at home, compared with those born at the hospital setting. This is a pioneer and preliminary study that brings attention concerning differences in Apgar score related to home versus hospital place of birth in Brazil.

Up to My Neck in Deliveries

Lovie ◽  
2016 ◽  
Author(s):  
Lisa Yarger
Keyword(s):  
North Carolina ◽  
Home Birth ◽  
Health Department ◽  
Home Births ◽  
The North ◽  
Dark Ages ◽  
County Health Department ◽  
Hospital Births ◽  
Beaufort County ◽  
At Home

Lovie’s marriage takes her to the North Carolina town of Washington, where she takes a job with the Beaufort County Health Department and starts attending home births on the side. Lovie describes working under the granny law, given that North Carolina had no law at the time to regulate the practice of nurse-midwifery. At her job, she faces opposition from nursing colleagues prejudiced against midwifery who claim she is taking their profession “back to the dark ages.” Her prejudices against hospital births deepen after she has two babies at home and two in the hospital. This chapter also discusses Lovie’s departure from the health department in 1957 to embark on a solo home birth practice and chronicles the death of her husband, Marshall Shelton.

scholarly journals Differences in optimality index between planned place of birth in a birth centre and alternative planned places of birth, a nationwide prospective cohort study in The Netherlands: results of the Dutch Birth Centre Study

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e016958 ◽  
Author(s):  
Marieke A A Hermus ◽  
Marit Hitzert ◽  
Inge C Boesveld ◽  
M Elske van den Akker-van Marle ◽  
Paula van Dommelen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Home Birth ◽  
Low Risk ◽  
Place Of Birth ◽  
Home Births ◽  
Birth Centre ◽  
Hospital Births

ObjectivesTo compare the Optimality Index of planned birth in a birth centre with planned birth in a hospital and planned home birth for low-risk term pregnant women who start labour under the responsibility of a community midwife.DesignProspective cohort study.SettingLow-risk pregnant women under care of a community midwife and living in a region with one of the 21 participating Dutch birth centres or in a region with the possibility for midwife-led hospital birth. Home birth was commonly available in all regions included in the study.Participants3455 low-risk term pregnant women (1686 nulliparous and 1769 multiparous) who gave birth between 1 July 2013 and 31 December 2013: 1668 planned birth centre births, 701 planned midwife-led hospital births and 1086 planned home births.Main outcome measurementsThe Optimality IndexNL-2015, a tool to measure ‘maximum outcome with minimal intervention’, was assessed by planned place of birth being a birth centre, a hospital setting or at home. Also, a composite maternal and perinatal adverse outcome score was calculated for the different planned places of birth.ResultsThere were no differences in Optimality Index NL-2015 for pregnant women who planned to give birth in a birth centre compared with women who planned to give birth in a hospital. Although effect sizes were small, women who planned to give birth at home had a higher Optimality Index NL-2015 than women who planned to give birth in a birth centre. The differences were larger for multiparous than for nulliparous women.ConclusionThe Optimality Index NL-2015 for women with planned birth centre births was comparable with planned midwife-led hospital births. Women with planned home births had a higher Optimality Index NL-2015, that is, a higher sum score of evidence-based items with an optimal value than women with planned birth centre births.

Joy and Kenny

Lovie ◽  
2016 ◽  
Author(s):  
Lisa Yarger
Keyword(s):  
Home Birth ◽  
Hospital Births ◽  
Beaufort County

Narrator Lisa Yarger asks Lovie about the possibility of accompanying her to a birth. Lovie tries and fails to get one of her Mennonite clients to meet Yarger. Yarger gives Lovie Chris Bojalian’s novel Midwives, which Lovie mistakes for nonfiction. Lovie hits upon the idea of introducing Yarger to her newest client, Joy Mitchell of Pantego, who grew up in the Dutch-American community of Terra Ceia in northern Beaufort County. This chapter includes the story of how Joy and her husband Kenny Mitchell decide on a home birth for the delivery of their fourth child after three dissatisfying hospital births.

Coming Home

2019 ◽  
Author(s):  
Wendy Kline
Keyword(s):  
Home Birth ◽  
The United States ◽  
Complete Control ◽  
Demographic Trend ◽  
Quiet Revolution ◽  
Hospital Births ◽  
Medicine And Culture ◽  
Alternative Organizations ◽  
Medical Protocols

By the mid-twentieth century, two things appeared destined for extinction in the United States: the practice of home birth and the profession of midwifery. In 1940, close to half of all U.S. births took place in the hospital, and the trend was increasing. By 1970, the percentage of hospital births reached an all-time high of 99.4%, and the obstetrician, rather than the midwife, assumed nearly complete control over what had become an entirely medicalized procedure. Then, seemingly out of nowhere, an explosion of new alternative organizations, publications, and conferences cropped up, documenting a very different demographic trend; by 1977, the percentage of out-of-hospital births had more than doubled. Home birth was making a comeback, but why? A quiet revolution spread across cities and suburbs, towns and farms, as individuals challenged legal, institutional, and medical protocols by choosing unlicensed midwives to catch their babies at home. Drawing on archival materials and interviews with midwives, doctors, and home birth consumers, Coming Home analyzes the ideas, values, and experiences that led to this quiet revolution, and its long-term consequences for our understanding of birth, medicine, and culture.

scholarly journals Professionally responsible counseling about birth location during the COVID-19 pandemic

2020 ◽  
Vol 48 (5) ◽  
pp. 450-452 ◽  
Author(s):  
Amos Grünebaum ◽  
Laurence B. McCullough ◽  
Eran Bornstein ◽  
Risa Klein ◽  
Joachim W. Dudenhausen ◽  
...  
Keyword(s):  
Home Birth ◽  
Neonatal Morbidity ◽  
The United States ◽  
Adverse Outcomes ◽  
Hospital Birth ◽  
Informed Decisions ◽  
Difficult Time ◽  
Control And Prevention ◽  
Obstetric Emergencies ◽  
Hospital Births

AbstractIf the worries about the coronavirus disease 2019 (COVID-19) pandemic are not already enough, some pregnant women have been questioning whether the hospital is a safe or safe enough place to deliver their babies and therefore whether they should deliver out-of-hospital during the pandemic. In the United States, planned out-of-hospital births are associated with significantly increased risks of neonatal morbidity and death. In addition, there are obstetric emergencies during out-of-hospital births that can lead to adverse outcomes, partly because of the delay in transporting the woman to the hospital. In other countries with well-integrated obstetric services and well-trained midwives, the differences in outcomes of planned hospital birth and planned home birth are smaller. Women are empowered to make informed decisions when the obstetrician makes ethically justified recommendations, which is known as directive counseling. Recommendations are ethically justified when the outcomes of one form of management is clinically superior to another. The outcomes of morbidity and mortality and of infection control and prevention of planned hospital birth are clinically superior to those of out-of-hospital birth. The obstetrician therefore should recommend planned hospital birth and recommend against planned out-of-hospital birth during the COVID-19 pandemic. The COVID-19 pandemic has increased stress levels for all patients and even more so for pregnant patients and their families. The response in this difficult time should be to mitigate this stress and empower women to make informed decisions by routinely providing counseling that is evidence-based and directive.

Supporting and Sharing—Home Birth

2014 ◽  
Vol 9 (5) ◽  
pp. 421-429 ◽  
Author(s):  
Maija-Riitta Jouhki ◽  
Tarja Suominen ◽  
Päivi Åstedt-Kurki
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Home Birth ◽  
Point Of View ◽  
Public Health Services ◽  
Birth Process ◽  
Study Results ◽  
Qualitative Interview Study ◽  
Hospital Births ◽  
Planned Home Birth

The planned home birth has provoked discussion around the world. Home birth has been described as a positive experience, but results regarding the safety of home birth are controversial. To date, the phenomenon has mainly been examined from the mother’s point of view, and there is only one previous study reporting fathers’ perspective. The purpose of the present phenomenological qualitative interview study was to investigate fathers’ experiences of planned home birth. Eleven fathers were interviewed, and the data were analyzed using Colaizzi’s phenomenological method. The fathers followed the woman’s wish in choosing the birthplace and set aside their own views. Furthermore, hospital birth was not an option for the fathers due to their own prior negative experiences of hospital births such as disturbing the natural progress of birth. The fathers’ experience of home birth included sharing the responsibility, supporting the woman, and participating in the home birth process. The experience was challenging; fathers had to take the role of a midwife, and no support or information on organizing home birth was offered by public health services. The fathers felt that the home birth connected them as family, and the experience was empowering. Our study results suggest that the health care professionals need more education and information on home birth and that the families (including fathers) interested in home birth need greater support from health care professionals. There is a need for proper national home birth guidelines, while family-and client-centered care has to be improved in birthing hospitals.

Midwife-assisted planned home birth: an essential component of improving the safety of childbirth in Sub-Saharan Africa

2018 ◽  
Vol 47 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Aliyu Labaran Dayyabu ◽  
Yusuf Murtala ◽  
Amos Grünebaum ◽  
Laurence B. McCullough ◽  
Birgit Arabin ◽  
...  
Keyword(s):  
Perinatal Mortality ◽  
Developing World ◽  
Home Birth ◽  
Sub Saharan Africa ◽  
Ethical Challenges ◽  
Home Births ◽  
Mortality And Morbidity ◽  
Sub Saharan ◽  
Hospital Births ◽  
Planned Home Birth

Abstract Hospital births, when compared to out-of-hospital births, have generally led to not only a significantly reduced maternal and perinatal mortality and morbidity but also an increase in certain interventions. A trend seems to be emerging, especially in the US where some women are requesting home births, which creates ethical challenges for obstetricians and the health care organizations and policy makers. In the developing world, a completely different reality exists. Home births constitute the majority of deliveries in the developing world. There are severe limitations in terms of facilities, health personnel and deeply entrenched cultural and socio-economic conditions militating against hospital births. As a consequence, maternal and perinatal mortality and morbidity remain the highest, especially in Sub-Saharan Africa (SSA). Midwife-assisted planned home birth therefore has a major role to play in increasing the safety of childbirth in SSA. The objective of this paper is to propose a model that can be used to improve the safety of childbirth in low resource countries and to outline why midwife assisted planned home birth with coordination of hospitals is the preferred alternative to unassisted or inadequately assisted planned home birth in SSA.

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