The American College of Obstetricians and
Gynecologists’ Committee on Obstetric Practice has issued a Committee
Opinion and recommends the following regarding planned home birth:
• Women inquiring about planned home birth should be
informed of its risks and benefits based on recent evidence.
Specifically, they should be informed that although planned home birth
is associated with fewer maternal interventions than planned hospital
birth, it also is associated with a more than 2-fold increased risk of
perinatal death (1 to 2 in 1,000) and a 3-fold increased risk of
neonatal seizures or serious neurologic dysfunction (0.4 to 0.6 in
1,000). These observations may reflect fewer obstetric risk factors
among women planning home birth compared with those planning hospital
birth. Although the American College of Obstetricians and Gynecologists
(the College) believes that hospitals and accredited birth centers are
the safest settings for birth, each woman has the right to make a
medically informed decision about delivery.
• Women should be informed that several factors are
critical to reducing perinatal mortality rates and achieving favorable
home birth outcomes. These factors include the appropriate selection of
candidates for home birth; the availability of a certified
nurse–midwife, certified midwife or midwife whose education and
licensure meet International Confederation of Midwives’ Global Standards
for Midwifery Education, or physician practicing obstetrics within an
integrated and regulated health system; ready access to consultation;
and access to safe and timely transport to nearby hospitals.
• The Committee on Obstetric Practice considers
fetal malpresentation, multiple gestation, or prior cesarean delivery to
be an absolute contraindication to planned home birth.
Citation:
American College of Obstetricians and Gynecologists’ (the College)
Committee on Obstetric Practice, et al. Planned home birth. Committee
Opinion No. 669. Obstet Gynecol. 2016;128:26-31.
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