Homebirth Essay

Advantages and Disadvantages of Birthing at Home, Birth Center, and Hospital

Before becoming a client of Women's Health and Birth Care, we would like for you to become familiar with your options and the advantages and disadvantages of each. Please read the following and feel free to ask any questions.

Advantages of home birth...

  • Statistics show that home birth is as safe or safer than hospital birth for low-risk women with adequate prenatal care and a qualified attendant.
  • At home a woman can labor and birth in the privacy and comfort of the familiar surroundings of her own home, surrounded by loved-ones. in whatever positions and attire she finds most comfortable.
  • The laboring woman maintains control over everything impacting her labor and birth. Meeting her needs is the only focus of all those present. Nothing is done to her without her consent.
  • Labor is allowed to progress normally, without interference and unnecessary interventions.
  • Studies show that the risk of infection is reduced for both the mother and the baby.
  • During labor the woman is encouraged to eat, drink, walk, change positions, make noise, shower, bathe, etc.
  • Care-givers are invited guests in the birthing woman's home. She can have anyone she desires present: family, friends, children, etc. Her medical team (midwife and birth assisiant) do not go home because their shift has ended or because it was supposed to be their day off or because it is a holiday or because they planned something else.
  • She doesn't have to worry about when to go to the hospital since her care-providers come to her.
  • Continuous one-on-one care is given by the midwife, providing ongoing assessment of the baby's and mother's condition throughout the birth process and postpartum period. Her care provider knows her well and she knows her care provider. They have established a trust relationship.
  • Women are supported through the hard work of labor, and encouraged to realize the insights, and experience the personal growth as a human being to be derived from such a powerful, life-changing event.
  • Bonding is enhanced and includes everyone who has contact with the baby including neighbors and relatives. Breast feeding is facilitated by the baby remaining with the mother.
  • Cesarean Section and forceps deliveries are unavailable - transportation to the hospital is necessary if these interventions are required. However, rates of both, as well as episiotomy, are very low.
  • The cost of a home birth may be less than a hospital birth, and is often covered by insurance if a CNM is utilized.
  • Pregnancy and birth are viewed as normal, natural body functions and not as an illness or disease.

Disadvantages of home birth...

  • Client's must assume a greater level of responsibility for their own health: physical, mental and spiritual. This requires active ongoing participation in decision making in all aspects of their care, and a willingness to accept the consequences of those choices and decisions.
  • Since the hospital is the currently socially acceptable location for birth, choosing otherwise may result in negative judgments and lack of support.
  • Cesarean Sections, forceps deliveries and a nconaialogist arc not available at home, transport is necessary for these and other medical interventions.
  • Personal arrangements must be made for postpartum care, such as meals, housekeeping, child care etc.
  • The cost of a home birth may not be covered by the client's insurance.
  • Analgesics are not readily available with a home birth.

Advantages of a birth center birth...

  • The facility is usually only provided for pregnancy and birth events.
  • In a birth center, pregnancy and birth is considered a natural and healthy process.
  • During pregnancy and birth, women arc encouraged to take charge of their own health care.
  • It provides an alternative to parents not comfortable with home birth, yet do not want to give birth in a hospital.
  • It has many of the same advantages as home birth, such as greater parental control, non-interventive obstetrical care, freedom to eat and move during labor, and to give birth in any position, and to have any number of family and friends attend the birth.
  • The parents are usually encouraged to bring family members to their prenatal visits.
  • It offers personalized care at much lower costs than traditional hospitals.
  • In most centers, parents can meet the entire staff prior to the birth.
  • The rate ofCesarcan and forceps deliveries is less than hospital.
  • The discharge time after birth is normally measured in hours, not days.

Disadvantages of a birth center birth...

  • Rigid screening criteria often eliminates healthy mothers, i.e.; VBAC, mother over 35.
  • The mother is still moved to birth center during labor, and still labors away from the home environment.
  • Many centers have rigid rules concerning transporting of the mother to the hospital i.e.; prolonged labor, ruptured membranes. Mother may have to be moved during labor.
  • There are usually no pediatricians on staff if the baby has special needs after the birth.
  • The mother cannot remain at the birth center for a two or three day rest; discharge is usually within four to 24 hours.

Advantages of a hospital birth...

  • Many mothers feel safest laboring a hospital.
  • It is the safest environment for the mother at risk for medical complications during labor.
  • Emergency personnel and equipment is available if the mother develops complications or needs medical attention.
  • It avoids the rush of a last-minute transfer to the hospital (from home or a birth center) if medical problems arise.
  • It is the only option available in the event a cesarean section is necessary.
  • Immediate pediatric attention is available should the newborn need medical care. Baby does not need to be taken off site to be routinely examined by a pediatrician.
  • It has round-the-clock help for the mother and baby (food, diaper changes, medical assistance and information.)

Disadvantages of a hospital birth...

  • The parents are not on "home ground" and do not have the same control they would at home.
  • Hospitals are primarily associated with illness.
  • Hospitals can seem impersonal and intimidating.
  • As a large institution, the hospital has rules, policies and red tape; they are rarely altered to accommodate an individual.
  • Less privacy is available.
  • The father is often less actively involved in a hospital setting, and may fell like an "outsider".
  • The mother's birth is usually managed by experts trained in pathology, not normal births.
  • The risk of iatrogenic complications and infection to the mother and baby is greater among mothers who deliver in hospitals, than among those who give birth at home or in a birthing center.
  • The mother is at a significantly higher risk of having an unnecessary cesarean section.
  • Some routine separation of the mother and baby is almost unavoidable.
  • Most hospitals do not allow the mother much rest.

Home Birth Essay

Home birth is not an unusual occurrence for certain areas in our country. It has been practiced by traditional midwives and untrained birth attendants for many decades, since before the existence of modern medical facilities and hospitals. However by improving our health care system for pregnant women, it has managed to reduce catastrophic complications that lead to maternal and perinatal death.
Why then are there still a few women keen for home birth although they have access to local area hospitals? Surprisingly the majority of these women are those with a formal education. This however does not include those who deliver at home due to unbooked or unwanted pregnancies. There could be a few reasons why:
Feeling of self control and more satisfaction with home birth
Religious belief that requires only female birth attendants
To avoid unnecessary intervention such as instrumental delivery or caesarean section
More natural birth experience, without involvement of drugs or analgesia

In certain countries such as the United Kingdom (UK), home birth is allowed for low risk pregnancies after proper counseling during their antenatal follow up. Home births are one of their norms as the number of the trained midwives is more than enough to take care of pregnant women in certain areas. Good access to communication services, short distances to area hospitals and experienced midwives who have received accreditation from the Midwifery Colleges in the UK make this service applicable to their area.

“Last time, all our grandmothers delivered normally in the village. There was no need to go to a hospital”

That was one of the common statements heard, especially from older members of the population. Well, I would say that is true but bear in mind there was a higher rate of death among mothers and babies during deliveries. Most of them were not reported at the time and hidden from us. Children with disability were born due to unknown brain injuries or lack of oxygen during deliveries.

So, is Malaysia is ready for home birth services? In my opinion, not yet. There are a lot of things that need to be improved before it can be implemented in our country.

Post partum hemorrhage or massive bleeding after delivery is still the most common cause of maternal death around the world and we are trying to reduce this incidence. Some maternal deaths in rural areas due to this problem are still under reported.
Our traditional midwives are not well equipped with certain instruments and training to handle emergency or life threatening situations. Nowadays, traditional midwives are being trained by health care personnel and they are labeled trained birth attendants but they still require more training and accreditation before being able to work independently. However, they recognize their own limitation and when to refer urgently to the hospital.

Source: www.panoramio.com
The government is building more district hospitals and clinics in rural areas for better access to health...

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