Notes on home birth: Safety, interventionism and satisfaction

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.

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Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2011.01.031 ◽

2011 ◽

Vol 204 (4) ◽

pp. e16 ◽

Cited By ~ 10

Author(s):

Russell S. Kirby ◽

Jordana Frost

Keyword(s):

Home Birth ◽

Newborn Outcomes ◽

Hospital Births ◽

Planned Home Birth ◽

Maternal And Newborn

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Supporting and Sharing—Home Birth

American Journal of Men s Health ◽

10.1177/1557988314549413 ◽

2014 ◽

Vol 9 (5) ◽

pp. 421-429 ◽

Cited By ~ 4

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.

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

Journal of Perinatal Medicine ◽

10.1515/jpm-2018-0066 ◽

2018 ◽

Vol 47 (1) ◽

pp. 16-21 ◽

Cited By ~ 2

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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Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2010.05.028 ◽

2010 ◽

Vol 203 (3) ◽

pp. 243.e1-243.e8 ◽

Cited By ~ 127

Author(s):

Joseph R. Wax ◽

F. Lee Lucas ◽

Maryanne Lamont ◽

Michael G. Pinette ◽

Angelina Cartin ◽

...

Keyword(s):

Home Birth ◽

Newborn Outcomes ◽

Hospital Births ◽

Planned Home Birth ◽

Maternal And Newborn

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Faculty Opinions recommendation of Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.4279956.4084054 ◽

2010 ◽

Author(s):

Cynthia Farquhar

Keyword(s):

Home Birth ◽

Newborn Outcomes ◽

Hospital Births ◽

Planned Home Birth ◽

Maternal And Newborn

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A Gap in Brain Gain for Emerging Countries: Evidence of International Immigration on Non-Resident Patents

Journal of Risk and Financial Management ◽

10.3390/jrfm14010007 ◽

2020 ◽

Vol 14 (1) ◽

pp. 7

Author(s):

Bolortuya Enkhtaivan ◽

Jorge Brusa ◽

Zagdbazar Davaadorj

Keyword(s):

Developed Countries ◽

Emerging Countries ◽

Culture Learning ◽

Host Countries ◽

Creative People ◽

Brain Gain ◽

Ample Evidence ◽

The World ◽

Controversial Topic ◽

Global Data

Immigration is a controversial topic that draws much debate. From a human sustainability perspective, immigration is disadvantageous for home countries causing brain drains. Ample evidence suggests the developed host countries benefit from immigration in terms of diversification, culture, learning, and brain gains, yet less is understood for emerging countries. The purpose of this paper is to examine the presence of brain gains due to immigration for emerging countries, and explore any gaps as compared to developed countries. Using global data from 88 host and 109 home countries over the period from 1995 to 2015, we find significant brain gains due to immigration for emerging countries. However, our results show that there is still a significant brain gain gap between emerging and developed countries. A brain gain to the developed host countries is about 5.5 times greater than that of the emerging countries. The results hold after addressing endogeneity, self-selection, and large sample biases. Furthermore, brain gain is heterogenous by immigrant types. Skilled or creative immigrants tend to benefit the host countries about three times greater than the other immigrants. In addition, the Top 10 destination countries seem to attract the most creative people, thus harvest the most out of the talented immigrants. In contrast, we find countries of origin other than the Top 10 seem to send these creative people to the rest of the world.

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