Translated material
Home births are gaining popularity
Home births are becoming increasingly popular . In the USA in 2022, for example, about 47 thousand were registered - which is 56% more than in 2016. However, childbirth without qualified medical care can lead to serious consequences - disability or infections in the child and mother, and even death. For example, in February 2023 in Crimea, a baby died during a home birth. “Kholod” figured out why women began to more often decide to give birth at home, what risks and consequences such births have for mother and child, and what doctors think about this.
But they can lead to disability and even death
It is impossible to carry out important medical procedures at home immediately after birth. For example, in the hospital, newborns are given infection prevention: vaccinations against hepatitis B and tuberculosis. During home births, these procedures are postponed - and these are big risks for the child’s health. Home birth should only be performed after consultation with a doctor and with serious preparation.
What is a home birth like?
Home birth can be planned , when a woman deliberately chooses to give birth at home. Among the staff in such conditions, there is usually an obstetrician or doula - an assistant without medical education who supports a woman during pregnancy and childbirth. They carefully prepare for such births in advance - they undergo medical examinations, ultrasounds, tests, find out the location of the fetus and assess the risks to the health of the mother and child.
Unlike other countries (USA, UK, Netherlands, Germany, Denmark, Ireland, Italy), in Russia the presence of an obstetrician or medical specialist at a home birth is considered illegal .
Also, home births can be unplanned - when a woman starts having contractions, but does not have time to get to the hospital. At home, women give birth in the way that is most convenient for them. For example, on a bed or sofa that is covered with waterproof sheets. Another option is a warm bath or a special pool of warm water, which helps relax and reduces pain during contractions. Sometimes a birthing chair is used for a comfortable upright position. The umbilical cord is also cut at home.
Why do women prefer to give birth at home?
This option is chosen for various reasons.
They have negative experiences of going to hospitals and antenatal clinics : some women feel fear after their first birth in a maternity hospital, remembering the negligence of doctors, the stress they experienced and severe pain.
Many have psychological trauma after undergoing medical interventions and operations (examinations, surgeries).
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Women often do not trust the quality of medical care : they are afraid of forced medical procedures (such as, for example, episiotomy - an incision between the anus and vagina, cesarean section, puncture of the amniotic sac), as well as obstetric aggression and violence during childbirth.
At home they will have the support of loved ones and comfort . Strangers and the hospital atmosphere can worsen a woman’s emotional state and cause stress and tension.
Many have financial constraints —people on low incomes often cannot access quality medical care, which can make home birth seem more affordable to them. In Ethiopia, for example, almost 73% of women give birth at home for these reasons.
In some cultures and religions, home birth is considered the norm . For example, about 22% of women in India prefer to give birth at home. Many ( 16% ) home births also take place in the Netherlands due to the local healthcare system. But in Russia the statistics are comparable to other developed countries: about 1.5% , although in a number of regions the number of cases is growing .
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On forums and social networks, women often share their experiences of home birth. Some note that they liked the cozy atmosphere, the absence of strangers and unwanted medical interventions, such as injections or puncture of the amniotic sac.
Others talk about difficulties, doubts and intense pain. For example, one girl did not manage to get to the maternity hospital on time, so she had to give birth at home: “When we finally got to the maternity hospital, I had a lot of ruptures. The uterus miraculously remained intact.” Another woman recalls: “I thought I could handle the pain, but I would rather get the medication right away than be at home.”
What do the doctors say?
Most doctors believe that giving birth in a hospital is the safest option for mother and baby. This is especially important if a woman has risk factors : chronic diseases, mental disorders, age under 18 or over 35 years, this is her first birth, she has complications from previous pregnancies, multiple pregnancies, abnormal fetal position.
According to statistics , from 9.9% to 31.9% of women who give birth at home for the first time are still transferred to the hospital - due to complications, the need for emergency pain relief, high blood pressure or injury and bleeding.
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When giving birth at home, you should have a phone on hand, plan in advance the route to the nearest maternity hospital and prepare a bag with things in case of emergency hospitalization.
In addition, in the event of injury or death of a child, the mother may face criminal liability under the articles of the Criminal Code of the Russian Federation “ Leaving in danger ” and “ Causing death by negligence ”, and for a doctor or midwife - for “ Illegal performance of medical activities ”.
Thus, in 2020, a resident of Magadan was sentenced to a year and a half of restriction of freedom for the death of a child during a home birth. And in 2023, a newborn in Crimea suffocated in the birth canal, and now his mother faces imprisonment for manslaughter.
What else is dangerous about home birth?
The American College of Obstetricians and Gynecologists (ACOG) notes that home births minimize medical interventions—obviously no labor induction, cesarean section, or vaginal incision—but increase the likelihood of postpartum complications by three times and the risk of newborn death by two times. . The birth of a child may be accompanied by complications that cannot be predicted:
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Fetal hypoxia . Weak contractions and insufficient dilatation of the cervix can slow down the baby's progress through the birth canal, which can result in the baby suffering from oxygen deprivation, suffocation, and injury.
Incorrect fetal position . If the baby is not positioned head down in the uterus, it may be injured when passing through the birth canal or even get stuck in it. Such cases require emergency surgery.
Cerebral palsy (CP). Hypoxia and trauma at birth are common causes of cerebral palsy. When there is a long-term lack of oxygen, brain cells are damaged, causing neurological disorders.
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Bleeding and injury in the mother. For example, rupture and inversion of the uterus, rupture of the genital organs, prolapse of the pelvic organs. Without medical intervention, this leads to blood loss, disability and even death.
Infections. Without sterile conditions and medical supervision, the risk of developing infections (purulent-septic diseases) in the child and mother increases.
Meconium aspiration. The baby may ingest amniotic fluid containing meconium (original stool), which can lead to breathing problems, pneumonia, and other respiratory complications. If this fluid enters the mother's bloodstream , it can cause allergy-like reactions, heart and respiratory failure, and even death.
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Author: Kholod editorial staff Photo: Westend61 / Getty Images