Would-be moms these days have several options when it comes to birthing. Normal birth, CS birth, natural birth, done in either hospitals, lying-ins, or birthing homes. Recently, another option came into the spotlight — home birth.
Home births are not new in the country. But celebrities — the most recent of which was Max Collins, doing it has somewhat renewed the public’s interest in it. But we have to ask, what exactly is home birth?
What is home birth and what does the DOH say about it?
Home birth is defined as the instance of giving birth at home instead of a medical facility such as a hospital, lying-in clinic, or birthing home. It is quite a common practice in provinces across the country, especially those who might have limited access to healthcare facilities. In these areas, moms often rely on midwives or kumadrona to assist them in their labor and delivery. The responsibility of registering the child more often falls on either the midwife or the parents themselves.
However, the Department of Health (DOH) issued Administrative Order (AO) 2008-0029, entitled “Implementing Health Reforms for the Rapid Reduction of Maternal and Neonatal Mortality.” Subsequently (and unofficially) dubbed as the “no home birthing policy,” it’s the department’s response to the high maternal and infant mortality rate in recent years. It states that pregnant women should only give birth in “facility-based centers,” specifically hospitals, lying-in centers, and other birthing facilities. At the same time, the delivery and births should be attended by “skilled health personnel,” identified as a “doctor, nurse, or midwife with proficiency in managing pregnancy and childbirth, including the appropriate management of complications that might occur.” The order also specified that the “facility-based centers” should be able to perform six medical procedures to ensure the health and safety of the mother and her newborn.
In response to claims that they’re “banning home births,” the DOH issued the Maternal, Newborn, Child Health and Nutrition (MNCHN) Strategy that provided guidelines on how AO 2008-0029 can be better implemented. The strategy takes into consideration local government units’ (LGU) “differences in local conditions and constraints” and therefore states that the LGUs can “design the implementation of the MNCHN strategy based on their local context.”
The LGUs then implemented their ordinances based on the DOH’s administrative order, manual of operations, and updated guidelines. An example of which is Quezon City, which passed an ordinance in 2012 that “prohibits home births” and “traditional birth attendants (TBA) to deliver babies and requires all professional health practitioners to deliver babies only in health facilities.” Violation of the said ordinance carries a PhP 5,000 fine.
Therefore, moms who are considering home birth should consider if their locale has a similar ordinance.
Why do moms choose to have a home birth?
For some moms, a planned birth is their only option especially if they live too far away from a facility-based center or transportation is a problem. Other moms choose it due to cultural or religious concerns, or even financial constraints.
Aside from these, other reasons moms can opt for it can include:
- A mom’s choice or desire to give birth without medical intervention, such as pain medication, labor augmentation, labor induction, or fetal heart rate monitoring
- A mom’s desire to give birth in a familiar setting, surrounded by family
- Anxiety or dissatisfaction associated with a medical or a hospital setting
- A mom’s desire for freedom and more control in the birth process
- Cultural, religious, or financial concerns
- Other health-related considerations, such as the COVID-19 pandemic
When are home births not recommended?
The American College of Obstetricians and Gynecologists does not recommend a planned home birth if:
- The mom is pregnant with multiples (twins or triplets)
- Your baby is in a breech or any other position that would not allow a headfirst delivery
- The mom previously had a C-section
What do moms need if they want to have a home birth?
A mom who wants to have a home birth delivery should prepare the following to minimize health risks for her and her baby:
- Choose and get the assistance of trained healthcare providers. It’s best to seek the assistance of a certified nurse-midwife, a certified midwife, a midwife whose education meets specific standards, or a doctor practicing obstetrics. Ensure that she also has access to other consultants or specialists in the hospital nearest you (or the hospital you intend to go to just in case). For additional support, you can also consider getting a doula.
- Create a birth plan. A birth plan is important in home births as this will detail your plans or methods to deal with labor pain, where you intend to have your labor and delivery and breastfeeding plans. It’s best to discuss each step with your healthcare providers and ask them the materials needed to prepare your home for your delivery.
- Prepare for a hospital transfer. Discuss with your healthcare provider the red flags that might entail you going to the hospital and how it will affect your birth plan. At the same time, make sure that you have the necessary transportation arrangements to facilitate the transfer. Complications that might require a hospital transfer include:
- Labor is not progressing
- Your baby is showing signs of distress
- Your baby presents a position other than headfirst
- You need pain medication/relief
- You have high blood pressure
- You experience bleeding
Remember mommies that while it is up to us to decide on our birth and delivery, our baby and our safety should always come first.