Many pregnant women who want to give birth at home. There are many reasons, for example because it is more comfortable and does not have to bother going to the hospital or maternity hospital, to the desire to go through labor while surrounded by family. However, is it safe to give birth at home?
If the condition of the mother and baby are healthy, the birth process can actually be done at home, although it is better to do it in a complete medical facility. However, even though it is better to give birth in a medical facility, some hospitals or maternity homes limit or even do not give permission to family members to accompany pregnant women during childbirth.
This is actually intended so that the family does not interfere with the doctor or midwife when trying to help the mother and baby during the delivery process. However, these restrictions have become one of the considerations for most pregnant women to give birth at home.
Is it Safe to Give Birth at Home?
A number of studies abroad show that giving birth at home is as safe as giving birth in a hospital, especially if the mother and baby are at low risk of complications during childbirth.
However, there is no domestic research that can ensure that giving birth at home is safe to do. In addition, keep in mind that during labor the mother must always be accompanied by a midwife or doctor.
This is because during labor pregnant women may require certain medical treatment, such as induction, episiotomy, or even caesarean section.
Apart from the reason for the need for certain medical actions, the distance between the house and the hospital or maternity hospital must also be quite close. The reason is that when delivery does not go smoothly, the mother can be immediately referred to the hospital. Therefore, doctors and midwives prefer to give birth in hospital.
Some Requirements for Home Birth
Not all pregnant women can give birth at home. There are several things that need to be met so that you can have a safe delivery at home. Here are some of the conditions:
1. Good health condition
Mothers can give birth at home if the pregnancy is normal and not at risk. This can be known by routinely carrying out pregnancy checks to the obstetrician or midwife.
If you have certain conditions or complications that are at risk of causing interrupted labor, then the mother should give birth in a hospital. Some things that make a pregnant woman not recommended to give birth at home, namely:
- Have had a cesarean section in a previous delivery.
- Pregnant with twins.
- Fetal distress.
- Premature birth, ie birth with a gestational age of less than 37 weeks.
- Postmature pregnancy, i.e. gestational age of more than 41-42 weeks, but the fetus has not yet been born.
- The baby's position is breech.
- Having certain health problems during pregnancy, such as gestational diabetes, preeclampsia, or infection of the membranes during pregnancy.
If you have any of the conditions above, then the option of giving birth at home is certainly not recommended. This is because some of the conditions above require special treatment that must be carried out by an obstetrician at the hospital.
2. Not the first time giving birth
If you are pregnant for the first time, it is recommended that you give birth at a health facility, such as a maternity clinic, health center, or hospital. This is done to avoid risks that can harm you and your baby.
However, for the second and subsequent pregnancies, as long as you and the fetus in the womb are healthy, then it's okay to give birth at home, as long as there is a midwife or doctor to assist with the delivery.
3. Delivery assisted by a midwife or doctor
Make sure home deliveries are handled by obstetricians or midwives who have an official license to practice and good competence. If you choose to be assisted by a midwife, the midwife must be connected to the nearest obstetrician and hospital for emergencies.
During delivery, the midwife or doctor will periodically check the baby's pulse, temperature, blood pressure, and heart rate. After delivery, the condition of the mother and baby will be carefully examined. If the mother or newborn needs medical treatment, the doctor or midwife will refer to the hospital.
Even if you decide to give birth with the help of a midwife, you should still consult about the choice of giving birth at home with an obstetrician.
4. Adequate accommodation and facilities
Talk to your doctor about what to prepare for a home birth. In addition, make sure the midwife brings the equipment needed to perform emergency measures, such as oxygen, IVs, and supplies of medicines to stop postpartum bleeding.
Before approaching the due date (HPL), the midwife will usually assess whether your house is suitable as a birthing place, starting from the cleanliness of the house and the surrounding environment, as well as whether the house has access or is close to the nearest hospital.
5. Access to hospital for emergencies
In addition to the short distance, think about the availability of transportation to take you from home to the hospital. In addition, the ideal distance and travel time from home to the hospital is recommended no more than 15 minutes. The faster the travel time, the faster the handling can be done.
Conditions Requiring Referral to Hospital
The birth process is unpredictable. Labor that initially went smoothly, could suddenly experience problems. Some of the obstacles during labor that require delivery to be carried out in a hospital include:
- Fetal distress, for example due to umbilical cord entanglement.
- Labor is prolonged or not progressing.
- Problems with the placenta, such as placenta previa or the placenta is pulled out of the uterine wall before the baby is delivered (placental abruption).
- The amniotic fluid smells foul or has pus (the amniotic fluid is infected with bacteria).
- After delivery, the placenta does not come out or comes out incompletely.
- The fetus swallows meconium or its own stool.
- Babies are at risk of being born with severe breathing problems or having an Apgar score.
In Indonesia, childbirth is encouraged to be carried out in adequate health facilities.
However, giving birth at home is still an option for pregnant women who live in remote areas. Geographical conditions and limited access to puskesmas or hospitals make it easier for them to give birth at home with the help of a competent midwife.
However, not all pregnant women can choose to give birth at home. It takes a lot of preparation, knowledge about pregnancy, as well as physical and mental readiness to undergo a home birth.
It should be noted that the government still recommends pregnant women to give birth in adequate health facilities. This is done so that the delivery process can run safely.