I am five months pregnant with my first child. I have been watching videos of home births and I really think it is something I would like to do. My husband is not too keen about it though. What are the dangers? Can’t I have a safe delivery at home? Is there anything I need to know before I do this?

Apophia

Dear Apophia,

Home birth versus hospital birth, it is a very interesting dilemma. There are pros and cons of both situations.

A human baby birth is a very natural process and can occur anytime, anywhere. Babies have been born in airplanes, elevators, anywhere and at any time, so why not at home? A woman is more relaxed and comfortable at home. She can move about, keep as many people around as she likes during labour. Time is no constraint. An experienced woman or trained midwife can assist in comforting during labour pains and bringing out the baby.

Prior to delivery time, a doctor can be consulted regarding good aseptic precautions to be followed during delivery and to identify any signs of problem during delivery or in baby after delivery. However, the drawback is, if something goes wrong at the last moment, one has to rush to the hospital, precious time being spent in transportation.

The possible problems which can arise during labour are like premature rupture of membranes and leak of amniotic fluid, thus jeopardising life of the baby, non-progression of labour pains, transverse or oblique position of fetus, thus making it difficult for it to move etcetera. These carry risk of lives for both mother and the baby.

In contrast, in hospital, a woman is confined to a room, visitors and food may be restricted. She may feel uncomfortable and may worry about things back home. But her contractions and fetal heart beats are constantly monitored by transducers and sonography, the atmosphere is sterile. Anything going wrong can be managed and corrected immediately; hence there is increased safety for both mother and child.

In a hospital setting, if labour does not progress as expected, drugs are given to induce labour, which is monitored clinically. Even if a woman has severe excruciating pain or is unable to tolerate the pain, she can receive medicines to ease pain while not harming the baby.

Hence one should consider the advantages and disadvantages of both situations before deciding whether to deliver at home or in hospital. One should also consider the risk factors due to which one may not have a normal delivery.

There are other factors which may pose a risk to the safety of mother or child. These risk factors are having the first child at an older age, more than 30- 35 years, short stature, pelvic deformity, having a large sized baby as with uncontrolled diabetes, twin pregnancy, among others.

It is advisable to go for regular antenatal check-up and decide where to deliver, around time of labour, considering all factors.

Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital