Home birth

A home birth is an act of giving birth in one's own home. Prior to the advent of modern medicine, a residence or where the mother found shelter, rather than a hospital or dedicated birthing center, was the default type of birth location. You find a bed that has been slept on by the husband, wife and one or two children; it has frequently been soaked with urine, the sheets are dirty, and the patient's garments are soiled, she has not had a bath. Instead of sterile dressings you have a few old rags or the discharges are allowed to soak into a nightdress which is not changed for days.:p156The mother lies in a well-aired disinfected room, light and sunlight stream unhindered through a high window and you can make it light as day electrically too. She is well bathed and freshly clothed on linen sheets of blinding whiteness... You have a staff of assistants who respond to every signal... Only those who have to repair a perineum in a cottar's house in a cottar's bed with the poor light and help at hand can realize the joy.:157The uncertain evidence suggests intrapartum-related perinatal mortality (IPPM) for booked home births, regardless of their eventual place of birth, is the same as, or higher than for birth booked in obstetric units. If IPPM is higher, this is likely to be in the group of women in whom intrapartum complications develop and who require transfer into the obstetric unit.When it comes to home births vs hospital births, home births are strongly associated with worse outcomes. The increased rate of adverse outcomes of home births exists despite the reported lower risk profile of home birth. We emphasize that the increased risks of poor outcomes from the setting of home birth, regardless of attendant, are virtually impossible to solve by transport. This is because total time for transport from home to hospital cannot realistically be reduced to clinically satisfactory times to optimize outcome when time is of the essence when unexpected deterioration of the condition of either the fetal patient or pregnant patient occurs. A home birth is an act of giving birth in one's own home. Prior to the advent of modern medicine, a residence or where the mother found shelter, rather than a hospital or dedicated birthing center, was the default type of birth location. The word combination 'home birth' arose some time in the middle of the 19th century and coincided with the rise of births that took place in lying-in hospitals. Since women around the world left homes to give birth in clinics and hospitals as the 20th century progressed, the term 'home birth' came to refer to giving birth, intentionally or otherwise, in a residence as opposed to a hospital. Although the fact the women give birth is universal, the social nature of birth is not. Where, with whom, how, and when a woman gives birth is socially and culturally determined. Historically, birth has been a social event. For the most of humankind history of birth is equivalent to history of home birth. Hypothesis exists that birth was transformed from a solitary to social event early in human evolution. Traditionally and historically other women assisted women in childbirth. A special term evolved in the English language around 1300 to name women who made assistance in childbirth their vocation - midwife, literally meaning 'with woman'. Yet midwife was a description of a social role of a woman who was 'with woman' in childbirth to mediate social arrangements for woman's bodily experience of birth. In the antebellum South nearly all middle- and upper-middle class women gave birth to their children in their own or someone else's home. Frequently southern women chose their parents' home for their confinement, especially of the firstborn. Some of the reasons to go to a parents' home were presence of an experienced mother, familiar physician or seasoned midwife, childhood friends, and/or parental pressure. Women who remained in their own homes for delivery recounted the following considerations for doing so: comfortable surroundings, presence of husband, family and friends as well as the impracticality, inconvenience and/or danger of travel Reputable historical research of maternal death rates in context of time, place, the number of births and in relation to other causes of mortality is scarce. Estimates of maternal deaths for English parishes from 16-19th centuries and Swedish parishes from 18-19th centuries revealed that deaths in childbirth formed an insignificant fraction of all deaths in women and posed insignificant risk of childbearing mortality. An international study of maternal deaths in childbirth in Great Britain, the United States, Australia and New Zealand between 1800-1950 confirmed that in context of the number of births, maternal deaths were rare. Most women in 17th-18th century were not fearful of pregnancy and birth. Modern research by Brigitte Jordan identified place of birth as the most salient how birth happens today. Modern scientific inquiry into home birth takes place in the fields of anthropology, epistemology, ethnology, history, jurisprudence, medicine, midwifery, public health, sociology, and women's studies. Research of home birth is complicated by ancient and modern biases about the nature of women and birth that are manifested in our language and ideas that we transmit about women, women's bodies, and what women do. It has been demonstrated that reports of research of physiological phenomena, such as conception, transmit deep seated biased cultural notions of women and women's bodies. Most last century and 21st century researchers of home birth view the phenomenon through two broad perspectives that are closely tied to the ideas and perceptions of birth itself - social and biomedical. Home births are either attended or unattended, planned or unplanned. Women are attended when they are assisted through labor and birth by a professional, usually a midwife, and rarely a general practitioner. Women who are unassisted or only attended by a lay person, perhaps their spouse, family, friend, or a non-professional birth attendant are sometimes called freebirths. A 'planned' home birth is a birth that occurs at home by intention. An 'unplanned' home birth is one that occurs at home by necessity but not with intention. Reasons for unplanned home births include inability to travel to the hospital or birthing center due to conditions outside the control of the mother such as weather or road blockages or speed of birth progression. Many women choose home birth because delivering a baby in familiar surroundings is important to them. Others choose home birth because they dislike a hospital or birthing center environment, do not like a medically centered birthing experience, are concerned about exposing the infant to hospital-borne pathogens, or dislike the presence of strangers at the birth. Others prefer home birth because they feel it is more natural and less stressful.:8 In a study published in the Journal of Midwifery and Women's Health, women were asked, Why did you choose a home birth? The top five reasons given were safety, avoidance of unnecessary medical interventions common in hospital births, previous negative hospital experiences, more control, and a comfortable and familiar environment. One study found that women experience pain inherent in birth differently, and less negatively, in a home setting. In developing countries, where women may not be able to afford medical care or it may not be accessible to them, a home birth may be the only option available, and the woman may or may not be assisted by a professional attendant of any kind. Some women may not be able to have a safe birth at home, even with highly trained midwives. There are some medical conditions that can prevent a woman from qualifying for a home birth. These often include heart disease, renal disease, diabetes, preeclampsia, placenta previa, placenta abruption, antepartum hemorrhage after 20 weeks gestation, and active genital herpes. Prior cesarean deliveries can sometimes prevent a woman from qualifying for a home birth, though not always. It is important that a woman and her health care provider discuss the individual health risks prior to planning a home birth.