If we asked our grandmothers where they gave birth, surely more than one would explain that they did it at home, because before there was no means available now. Most children were born well, without problems, but some deliveries were problematic and the consequences were unpredictable.
With the advance of science and medicine and with the intention of preventing any problem, protocols were created in which the delivery passed to the health professionals, leaving the mother in the background so that the control was as exhaustive as possible. and so that, controlling all possible variables, the deliveries were safer.
The problem is that over the years it has been shown that an excess of control is also harmful to the mother and the baby and that it is necessary to retrace part of the path taken by medicine. As all changes are slow, many couples decide not to wait for the hospital to give more prominence and freedom to mothers and choose to give birth to their children at home. As this generates some doubts, we will try to answer today at five frequently asked questions about home birth.
1. What does WHO say about home birth?
When someone receives information about something they don't know or don't think may be possible, they always look for opinions from experts or arguments that can satisfy their curiosity and that's why I think it's important to comment on what the World Health Organization says about the possibility of giving home light
Already in 1985, WHO and the Pan American Health Organization drafted the so-called Declaration of Strength in which they explained how a birth should be and how it should be a birth. In it they said that every woman should be informed of the different methods of childbirth care, so that she can choose the type of delivery you prefer, and this includes the possibility of giving birth at home if there are no contraindications for it.
As you can see, this year will do 28 years of this and, seeing that not many things have changed, at least in Spain, it seems normal that many couples look for alternatives to hospitals.
2. Why give birth at home?
For two obvious reasons: to run away from hospitals, which happens when a hospital is reputed to use outdated protocols and respect women little, and why at home nowhere.
A pregnancy is not a disease, and certainly a birth is not a disease either. This means that if a couple goes to a hospital to give birth the only thing that would have to happen there is to be welcomed with a warm welcome, to be left in a quiet place to stay while everything progresses and to give birth with the Minimal intervention by professionals if everything goes well.
The problem is that that "childbirth is not a disease" has not yet penetrated in all hospitals and, although in some things are being done very well, in others they are still doing as before, knocking mothers to have them monitored, making unnecessary touches, talking to them too much (and thus not letting them focus on their birth) and other things that can make a normal delivery end more interventions than necessary.
Many couples, knowing that all women are prepared to give birth alone if they want, choose to give birth at home with someone's health care with the necessary knowledge and experience to attend a birth naturally (as I say, with the minimum necessary interventions).
In fact, even when things were done very well in a hospital, it seems that Home birth is lived more intensely and satisfactorily by being in your own environment, in your own house, and not in a foreign and transitory place.
3. Can all women give birth at home?
A few lines ago I said that all women are prepared to give birth alone. This is true, but it is not true that all women can give birth in their homes without problems because if this were true the delivery would never have moved to the hospital. In other words, nature is very wise, but not infallible at all, and that's why It is recommended to give birth to a hospital when the following situations occur:
- That the mother has a serious disease of the heart, kidney, respiratory, etc.
- That pregnancy is considered high risk (due to hypertension, diabetes, placenta previa, ...).
- That the delivery be premature (before 37 weeks of gestation) or post-term (after 42 weeks of gestation).
- That the baby does not come in a cephalic position.
- That you cannot guarantee professional health care at home or transfer to a health center in less than 10-15 minutes.
- That it is a pregnancy with more than one baby or that the woman has given birth by caesarean section in previous births.
4. Is it safe to give birth at home?
Although it is the fourth question, I must say that this should probably be the question that more couples ask themselves when they hear about a home birth: if it is safe or, asking the question in another way, if it is not more dangerous to give birth at home than in a hospital.
It is clear that the risk of problems at home delivery is not zero. No one can guarantee to a couple that there will be no problem during delivery at home. However, no professional from any hospital can make such a statement either, because some deliveries are also complicated in hospitals and there are also problems.
The grace of the matter is then to know if these risks are similar or if in one of the two places the risk is greater than in the other. Several studies have shown that home birth was more dangerous. A meta-analysis conducted in 2010 concluded, in fact, that the risk of neonatal death in a home birth was up to three times higher than in a hospital birth. However, it was a very criticized study because when it came to talking about home birth, it included risk pregnancies that ended accidentally at home and other deliveries where there was no health care. The same study, eliminating these factors, yielded very similar mortality data.
Another study conducted at the University of Alicante and which we talked about last year, analyzed term deliveries of a single baby and with healthcare, both at home and in a hospital and concluded that there were no significant differences in mortality rates and that therefore it was just as safe giving birth at home as in a hospital.
5. How much does it cost?
Unlike giving birth in a hospital, giving birth at home is not covered by social security and therefore it is the parents who must bear the costs of assistance. A little over a year ago we did in Babies and more a survey on this same topic and 73% of the readers were favorable to social security cover such expenses, as happens in Holland, where the situation is reverse: they charge you for go to give birth to a hospital.
As with the crisis it seems quite unthinkable that our presidents even think about attending mothers at home (although it would surely be cheaper for the state), the parents are, as I say, those who have to pay for assistance, that It ranges between 1,900 and 2,500 euros, which are based on the services and specialists that care for the mother and the baby. In addition to assistance, the cost usually includes pre-delivery visits, the availability of the midwife from week 37 and control visits after birth.
