LAST_UPDATESun, 22 Jul 2018 10am

Is Home Birth Safe? Know The Pros And Cons

Joyous moment of a mother who underwent a water-home birth in Australia. Pic:  Georgia Brizuela/ moment of a mother who underwent a water-home birth in Australia. Pic: Georgia Brizuela/ the social stigma being a norm when one comes across the term ‘home birth’ (assisted or not), especially with the advancement of medicinal technology, why would a pregnant woman opt going back to the old-ages on their choice of birthing?
This is simply because of the reason that many mothers-to-be in the present time are getting back to nature and taking matters into their own hands when it comes to their birth choices.
Despite the recent tragic death of new mom Ang Lay Chin, 40, who suffered excessive blood loss after going through a natural home birth to her first born, home birth is not as horrific as it seems if they followed the proper procedures.
While it is easy for some of us to pass judgment on Chin’s decision, home birth does not necessarily come with a risk for everyone as complications and death during child birth may occur whether at home or at the hospital.
In an email response from Obstetrics & Gynaecologist Dr. Paul Ng Hock Oon, unassisted home births are not recommended by the Ministry of Health (MOH) but home births are allowed under supervision of trained and experienced personnel.
The mother must be pregnant with her 2nd – 5th baby, not carrying multiple babies, has no family history of birth complications, etc., to be able to give birth at home in Malaysia.
The Pantai Medical specialist said, in case of unrecognised complications, it may cause unassisted home birth to become unsafe for the mother or the baby.
“While the incidence of complications may not be high in a global sense, they can be devastating to mother or baby if not addressed immediately,” he wrote to Malaysian Digest when contacted recently.
Identifying and assuring there are no risk factors during pregnancy, it is important for mothers who insist on home birth to have an experienced companion such as a midwife of a governing body who is able to recognise and handle complications that may occur during labour.
It is important to have a partner's love and support   /Google ImagesIt is important to have a partner's love and support /Google Images“The danger of unassisted births is because of lack of experience by the carer(s) to recognise potentially dangerous issues and this may be too late by the time the patient is taken to hospital,” he wrote.
While many women feel she has the need to deliver her baby at home, Dr Hock Oon encourages that there are obstetricians who are comfortable with practicing natural birthing, and allow patients their choice of birth within the limits of safety in the hospital. 
Certified childbirth educator from AMANI Birth Maria Zain said, mothers who decide on unassisted home birth vary in reasons. Some have been exposed to positive homebirth stories while others have had poor hospital experiences. The 33-year-old believes it is possible to have a natural birth in a hospital, given that one has to be particularly selective of their medical consultant's protocols.
“As a childbirth educator, we usually talk about the process of natural birth and how the female form has already been designed to birth. We do not shun medical intervention, but we encourage expectant parents to fully understand the benefits and risks of each intervention and encourage them to either give informed consent refusal. It's their right, either way.
“We also encourage parents to work closely with their care-providers prior and during births and discuss all procedures before consenting. In the end, not all mothers will give birth in hospitals. However, some choose to deliver at home unassisted, again due to the general lack of support. Although we don't agree with such options, we don't judge these parents, the same way we don't judge those who decide to have c-sections (even without medical conditions) as their birth choice,” she wrote in an email to Malaysian Digest.
Maria, who had home birthed three children after two prior hospital births, said home birth is not new in Malaysia and was a norm before the advent of hospital birth-normalcy.
There is not such movement for home birth in Malaysia that promotes home birth as the ultimate way of birth, but there is a growing interest and support in it as there is a group of women who feel more inclined to deliver at home.
Certified Hypno-Birthing childbirth practitioner and AMANI childbirth educator and doula (birth companion) in training Nadine Ghows said, a social movement on home birth is borne out of the fact that many mothers were traumatised, disrespected and had undergone many unnecessary intervention during their births. 
However, Nadine, who is also a breastfeeding Peer Counselor, stressed that unassisted home births is not for everyone and one should be in the know of the risks and benefits. The decisions should be made to fit the mother’s own particular circumstance.
“We need to stress on informed choice. Knowledge is power, so we have to find out more on why many women are turning to home birth; are they taking unnecessary risks, are they being irresponsible? There must be a reason,” she responded in an email.
Having given birth to two children, one unassisted at home, Nadine thinks that birth should be seen as a sacred life-event, and deserves as much honour and respect from both family and friends, and from society as a whole.
“For many mothers, home birth seems like the most logical thing to do. It is a primal act and happens when the mother feels safe, secure, loved and supported. Hormones released during birth are the same as those during sex and breastfeeding. The hormones are only released when a woman feels secure and comfortable, i.e. her own home, so it is natural for the mother to give birth in such environment thus making the delivery easier," she wrote.
Nadine also said that although there has been much debate on the safety of home births in recent years, many studies have cited that homebirths attended by qualified and skilled midwives are completely safe and have better outcomes for both mother and baby.
“There are a few studies that discredit this. Generally the medical community around the world are concerned about getting mothers into hospital and seen by a doctor. No surprises there - considering the medical community’s focus is on the physical realm in isolation from the human emotion and psyche,” she said.
Midwives are often under the jurisdiction of the hospital or doctor   /Google ImagesMidwives are often under the jurisdiction of the hospital or doctor /Google ImagesAs for midwifery, a more holistic approach to pregnancy and birth is taken. The birthing process is not only seen as a physical act, but it involves the mother’s emotions and mental state of mind.
Sadly, though assisted homebirth attended by midwife is legal in Malaysia, Nadine said the quality and skills of midwives in the country are not up to the international standard. They do not enjoy the autonomy of their practice as they are often under the jurisdiction of the hospital or doctor.
At the end of the day, the decision on how and where to deliver lies in the hand of the mother.
Though the practice of home birth in western countries is different, Malaysian women are looking into the alternative, since many mothers who opt for home births are not exactly uninformed of the choice they have made.
With the hike in private hospital fees, increased number of patients and a long waiting list in government hospitals, how could one not turn to the comfort of home birth, without the hassle, crowd, and unnecessary medical intervention?
However, it is important to be well informed; having gone to seminars, trainings and has done a thorough research on the subject, before making the final decision of having a home birth to minimise any possible risk.
- mD