Is home birth safe? See possible risks and necessary care

Gisele Bundchen 44, is pregnant with her first child with her boyfriend, the jiu-jitsu teacher Joaquim Valente 35. According to People magazine sources, the former model plans to give birth at her mansion.

THE home birth It is done in a home environment, either on a scheduled basis or in an emergency. Generally, pregnant women choose to give birth at home as they consider it to be a welcoming and peaceful place, where their family can be present.

“Home birth is carried out in a similar way to hospital birth. The patient goes into labor and she will be assisted and monitored by the team that is at her home”, explains Beatriz Cristofaro Mantuan, gynecologist and obstetrician at Clínica Paulista de Medicina Reproductiva (CPMR), to CNN .

Home births can include a bathtub with warm water, which helps to alleviate the pain of contractions in the pregnant woman, and must be accompanied by specialized professionals, such as an obstetrician, nurses and physiotherapists.

Risks of home birth

Although many pregnant women opt for home birth, the practice can pose risks to the baby and mother. The Ministry of Health, through Technical Note nº 2/2021does not recommend births carried out at home and defends the hospital environment as the safest place for birth, “mainly due to the availability of a complete care team, equipment for emergency assistance, among other technological inputs.”

The Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo), together with the Brazilian Medical Association (AMB), also does not recommend home birth and, in official position on the subject“reaffirms the commitment to always be allies of all pregnant women in Brazil, defending that all births in Brazil are carried out in adequate safety conditions, within properly structured Maternity Hospitals”.

“The risks are very high of an emergency happening and not having time to save the lives of this baby and the mother. [No parto domiciliar] We do not have enough resources to treat an emergency, be it hemorrhage, perinatal asphyxia or eclampsia, which is a seizure in the mother, or the need for a cesarean section”, explains Monique Novacek, obstetrician gynecologist at Clínica Mantelli, to CNN .

When opting for a home birth, it is essential to choose a location with a nearby reference hospital for emergency cases and it is preferable that an ambulance is present at the address. However, even taking these precautions, there is a risk that emergencies will arise and there will not be enough time to get to the hospital. “Some unforeseen events can happen at the time of birth, even when everything is going well during the pregnancy,” he adds.

Necessary care during home birth

Even with the known risks, many women opt for a planned home birth because they are looking for a more pleasant and familiar place to give birth to the baby, in addition to the desire to avoid supposed excessive medical interventions.

In this case, some precautions are essential to make home birth safer. THE The first step is to choose the professional team that will be on site at the time of birth. . “It is necessary to talk to the professionals and see if they agree to carry out the procedure, in addition to finding out if the pregnancy is very low risk and evaluating all the issues related to the baby, the placenta and understanding whether the woman has not had any complications, whether she has or I don’t deliver via previous cesarean section,” says Novacek.

It is also necessary to assess whether the baby is well fitted for natural birth and all prenatal exams must be up to date. “The medical team that will be present at the scene must be well prepared to deal with emergencies, that is, know how to resuscitate the baby if he is born with a cardiorespiratory arrest, take care in cases of hemorrhage, and make some medications available at home as well. In other words, it has to be something well prepared”, advises the gynecologist.

Ideally, the professionals involved in home births should be the same as those involved in hospital births, reiterates Mantuan. This includes at least an obstetrician, a neonatologist, nursing staff and a physiotherapist. “The bigger and more trained the team, the better,” he says.

Doulas may also be present to provide support to the patient, both physical and psychological. “They can calm, reassure and perform breathing exercises, for example,” adds Mantuan.

When is home birth contraindicated?

According to Novacek, the home birth is contraindicated in high-risk pregnancies such as in cases where the mother had high blood pressure during pregnancy, gestational diabetes, thrombophilia or if she uses prescription medication.

“Patients who have twin pregnancies and cases in which the baby is sitting, that is, anomalous presentations, transverse breech presentation, babies weighing more than four kilos, changes in the placenta, history of cesarean section or hemorrhage in previous births are also some of the examples in that home birth is not recommended”, says the gynecologist.

However, there is a caveat: “Ideally, there should be no home birth due to the risks of maternal mortality and neonatal mortality, in addition to possible consequences for the newborn”, concludes Mantuan.

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This content was originally published in Is home birth safe? See possible risks and necessary precautions on the CNN Brasil website.

Source: CNN Brasil

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