- 23April 2020
During the COVID-19 pandemic, would it be safer to plan a home birth rather than deliver my baby at a hospital?
Kristi L. Watterberg, MD, FAAP
No. Based on current evidence, the American Academy of Pediatrics (AAP) believes hospitals and accredited birth centers are still the safest places for babies to be born in the United States.
It’s easy to understand why parents-to-be may be worried about going to the hospital right now to have a baby. Many hospitals across the country are crowded with COVID-19 patients. We also know that some parents may be interested in planned home births for cultural or religious reasons or hopes for a more family-friendly setting.
|However, research shows planned home births in the United States are associated with an increased risk of newborn death (roughly 1-2 deaths for every 1,000 births). Babies born at home also may have a higher risk from medical complications and tend to have lower Apgar scores.|
While the AAP does not recommend planned home births, it recognizes some women will choose this option. It’s newly updated policy statement, “Providing Care for Infants Born at Home,” policy offers guidance to help support parents and help protect infants born at home.
AAP guidance on planned home births
If you’re considering a home birth, here are some AAP recommendations to keep in mind:
- Know your risk. Women with low-risk pregnancies are more likely to have a successful home birth. Talk with your doctor about medical problems that can raise the risk of complications.
- Have skilled providers with you. If you decide to have your baby at home, make sure you have two certified providers there with you. They should have the training, skills and equipment to perform a full resuscitation if they baby needs help starting to breath. Ideally, they should be a doctor or certified midwife who practices within a regulated health system.
- Be ready to go to the hospital if needed. Complications can happen even to women with low-risk pregnancies.
|Remember, if you end up having to go to the hospital for the birth of your child, this is not a failure of the home birth. Instead, it’s altering your plans and choosing a healthy outcome for you and your baby.|
- Consider how far away you are from the nearest hospital. Planned home births more than 15 or 20 minutes away from a hospital have a higher risk for complications, including newborn death.
- Keep an eye on the weather and any other problems that could prevent you from getting to the hospital quickly if problems come up. For example, if your local EMS is already overloaded due to the COVID-19 pandemic. Make sure phones are working and cell coverage is good.
Just like in the hospital, your baby will need to be closely monitored. This includes the baby’s temperature, heart rate, skin color, circulation, breathing, alertness, tone, and activity. These vitals should be recorded at least once every 30 minutes until your baby stays stable for 2 hours.
There are several other tests and screenings your baby needs within the first couple days after birth. Be sure to make an appointment to see your pediatrician within 24 hours after your baby is born and again within 48 hours of that first visit.
It might seem like a scary time to give birth in a hospital, but remember that maternity wards take every precaution to stay sanitary. In addition, hospitals are working to follow the latest infection control guidelines from the Centers for Disease Control and Prevention. If you are interested in a home birth, talk to your doctor about what you need to do to make the experience as safe as possible for you and your baby.
- American Academy of Pediatrics Issues Safety Recommendations on Home Births; Hospitals Remain the Safest Option Even Amid Coronavirus Pandemic
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