The idea of home childbirth and having a baby at home, in the family setting, attended by the local midwife and general practitioner, is very attractive to many mothers-to-be who do not feel at ease in hospital surroundings. Nearly all births up to 70 years ago were at home and still are in many developing countries. Although safe home delivery is perfectly possible for some women, the problem is how to know which women will be safe and which will not.
Home Childbirth Risks
Some of the complications of labor cannot be predicted and when things go wrong specialist help and equipment is urgently needed. For example, fetal distress during labor requires all the medical facilities that are necessary to rescue the baby quickly. This may involve a’ delivery or a Caesarean section. Post-partum haemorrhage is another complication which may require a life-saving blood transfusion and all the necessary facilities and equipment to give it.
Not so long ago, when there were insufficient maternity beds in hospitals and some women had to be delivered at home, arrangements were made to send help out from the hospital to those women who developed complications. The help came in the form of an obstetric flying squad which consisted of an obstetrician and anaesthetist and one or two midwives, plus the necessary medical equipment. Unfortunately, even the most practised flying squad could not reach the patient’s home without some delay and, during this time, the mother or baby could die.
Although the risks of home confinement are slight, most doctors and midwives think that they are sufficiently great to recommend a hospital delivery. In hospital, the necessary medical and obstetric help is available on the spot and so are the facilities for operative delivery and resuscitation of the baby. Early discharge from hospital after delivery, and the free access which most maternity units now give to fathers to be present and the family to visit, may not be quite so satisfying as home confinement, but a hospital confinement is safer for both mother and baby.