Are Home Births Worth the Risk?

For many women, the birth of their child is one of the most pivotal moments of their lives. Months of anticipation come to an end as contractions begin. While the majority of U.S. women travel to a hospital for delivery, many are considering home birth. Home births are desired because in them, women can feel relaxed, comfortable, empowered, and wrapped in intimacy, as their grandmothers, greats, and ancestors may have been.

Though most babies today are delivered in hospitals, the United States maintains the highest maternal mortality rate of any industrialized country. In fact, maternal mortality rates are actually increasing! The World Health Organization states that caesarian section rates of a healthy population should never exceed 15%, but U.S. rates have reached an average of 34% (WHO, 2009). Most cesareans performed in the U.S. are unnecessary, leaving women to deal with higher risks of infection, hemorrhage, and additional injury. When hospitals are shadowed with high intervention rates, and in Georgia, where rural populations are higher than the national average, home birth may seem like a good alternative.

Increasing in popularity, home births still account for less than 1% of all births. Where we choose to have our babies is an important decision, and problems may arise when couples are unaware of the hazards that accompany home births.

Midwives are sought because of their holistic approach to childbirth, providing both mother and newborn with emotional and physical care over an extended period. There are two major kinds of midwives:

  1. Nurse midwives (CNMs), like obstetricians, are medically trained and licensed to deliver babies in homes, birth centers, clinics, and hospitals. They have successfully graduated from an accredited university program and may legally practice in all states. Nurse midwives provide routine gynecological care and offer counseling and medical care during pre-conception, pregnancy, childbirth, and the postpartum period. In Georgia, although nurse midwives may legally oversee home births under the supervision of a physician, many Georgia doctors fear lawsuits and are unwilling to attend home births, hence restricting these nurses as well.
  2. The title of professional midwife or lay midwife (CPM) is virtually open to anyone. The title offers no implication of skill, education, or legal right to practice birthing. The midwives, though they may be experienced, hold no credentials or licensing. Also known as direct-entry midwives, professional midwives are usually uninsured, unrecognized, and unregulated by the state.

Choosing a midwife who carries malpractice insurance helps identify that the person being hired operates within some sort of accountability. In the event of negligence, families can receive compensation. However, lay midwives, unlicensed and unrecognized by the state, are not required to carry malpractice insurance and often do not. In the event of an accident, they may leave a family struggling with years of related costs.

In the instance that a midwife with no liability insurance transports an injured mother or baby to the hospital, the attending physician may end up responsible for damages. Because many malpractice insurance policies won’t cover a physician that participates in home births, most physicians refuse to collaborate with midwives who perform them.

As a preventative measure to filing a claim for a malpractice suit, hospital births are the safest option, as they are always insured.

Legally, women have the right to informed consent. Informed consent assures that patients are given appropriate information so that they may make a knowledgeable, voluntary choice to accept or refuse medical interventions. Providers tend to make a lot of assumptions about the basic knowledge patients may have about certain treatments and rarely take the time to explain the benefits and risks of specific drugs or procedures.

If you don’t understand what your provider is saying and you need more information, never hesitate to speak up. You reserve the right write in and cross things off any consent forms you are presented with. If you wish to refuse a specific treatment and the doctor performs it anyway, the doctor and hospital may be subject to criminal charges even if you and the baby are fine after the procedure.

However, there have been situations where women are deemed to have no legal rights to refusal. There have been recent trends where mothers were forced into caesareans, episiotomies, or induced labor against their will. Most notable, is the incident where a woman was charged with murder for refusing a C-section. Deemed medically necessary or overshadowed by hospital or procedure policy, lines can be fuzzy. The most appropriate legal course of action is dependent on the specific circumstances of the case.

In a home birth, circumstances depend upon your written contracts and agreements with your midwife. In both situations, it is critical to maintain a comfortable relationship with a physician or midwife you trust.

Home births are often associated with the stigma of riskiness, but it’s important to remember that there is no such thing as a “safe” or risk-free birth.

A poorly planned home birth with a less than competent medical provider can end in disaster. Do not attempt a home birth without first acknowledging these factors:

• Women dealing with chronic health issues such as diabetes or high blood pressure are encouraged not to have home births. Complications can arise and are better monitored, prevented, or treated in a hospital.
• Do not attempt a home birth if you have not had the necessary prenatal care.
• Credentials aside, choose a midwife who has attended plenty births and has an assistant.
• Plan for emergencies. What will happen if something goes wrong? Will you be transported to the hospital?
• As a preventative measure, make sure that your midwife is acquainted with a physician in a nearby hospital. If there is no relationship between the two or prenatal documentation is not shared, if you are to be admitted, you’ll merely be treated as an ER patient.
• Does the hospital nearest to where you plan on having your baby have a maternity unit? Is it equipped to deal with any issues that might arise?

While home births are technically legal in Georgia, laws, regulations, uncertainties, and a general absence of information make the process tedious and frustrating to maneuver. Please spend an ample amount of time in research before making the decision to initiate a home birth. The best birth scenario is one in which the mother is safe and comfortable.

When medical professionals fail to provide proper care, they must be held accountable. McAleer Law can take on your medical malpractice suit. If your baby suffered a birth defect or died because of negligent medical care or you are seeking legal counsel, please contact McAleer Law at (404)-MCALEER.

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