AAP’s New Home Birth Policy Implies There are No Worthwhile Benefits to Giving Birth at Home

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Due to a slow rising number of home births in America, the American Academy of Pediatrics (AAP) has released a new policy statement, “Planned Home Birth.” Published this week, in the May issue of Pediatrics, the AAP policy focuses on infant care after the birth, but offers other home birth tidbits as well. The policy also highlights what makes a woman a good candidate for home birth, which according to the AAP is as follows:

  • Women with absence of preexisting maternal disease.
  • Women free from significant diseases during pregnancy.
  • Women carrying one child, not multiples.
  • Women carrying babies with a cephalic presentation (i.e. head-first, not breech).
  • Women who carry their baby to term.
  • Women who experience spontaneous labor or who are induced as an outpatient.

The AAP also states that some very specific systems should be in place before a woman becomes a home birth candidate — including, availability of a certified nurse-midwife, certified midwife, or physician to deliver the baby, at least one trained individual to care for the newborn, access to consultation and access to safe and timely transport to a hospital if needed.

birth, home delivery, newborn, infant, home birth, homebirth, DIY birth, midwife birth
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What Else is Included in the Policy?

There are some helpful tips within this new policy. For example, the AAP points out some obvious facts, such as skin-to-skin contact with a mother is an effective baby warming system, but portable warmers should be made available as well. They remind home birth care providers that infants who need resuscitation should be monitored frequently, and if extensive resuscitation is necessary, an infant should be taken to a medical facility. Additionally, the AAP says that infant care during a home birth needs to include:

  • Basic care – cleaning, keeping baby warm, etc.
  • Universal newborn screening including hearing screening
  • Monitoring for group B streptococcal disease
  • Glucose screening
  • Eye prophylaxis against gonococcal ophthalmia neonatorum
  • Dose of vitamin K
  • Hepatitis B vaccination
  • Assessment of breastfeeding
  • Screening for hyperbilirubinemia
  • A plan in place for follow-up care for mom and baby

As you can see, many of the recommendations are very hospital-minded, including their recommendation that only doctors or midwives certified by the American Midwifery Certification Board should attend a home birth; something that’s rattled many other types of midwives.

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2 Responses to “AAP’s New Home Birth Policy Implies There are No Worthwhile Benefits to Giving Birth at Home”

  1. theseep says:

    The AAP is correct in that the only benefit is the perceived comfort to the parents, vs. the significant risk home birth presents to the fetus. As an ER physician, I’ve seen midwives bring crashing infants to the hospital – outcomes are horrible and could have been prevented by delivering in a birthing center with an OR and OB/GYN available for backup or in a typical hospital. From experience, I would strongly recommend against home births.

  2. elm says:

    Thank goodness midwives bring babies into the ER that need to be seen, that’s what they are paid for, to evaluate risk and treat infants within their realm of capability and transfer the rest. but have you ever looked at the statistics of homebirth midwives? the transfer rate is extremely low. the statistics of hospitals? risky interventions and drugs pose immediate and continuing problems to baby and mom. one can only offer an opinion on what they have experienced and researched. Thank you AAP for your recommendations and acknowledging a women’s right to birth where, how, and with whom they wish.

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