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Planned home birth: the professional responsibility response.
Frank A Chervenak1, Laurence B McCullough, Robert L Brent
1Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA.
American Journal of Obstetrics and Gynecology
|November 16, 2012
Summary
Planned home birth poses increased risks to mothers and newborns, despite claims of safety and satisfaction. Evidence shows high emergency transport rates and questions cost-effectiveness, urging physicians to recommend against it.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- Resurgence of midwife-supervised planned home birth in developed countries.
- Advocates cite patient safety, satisfaction, cost-effectiveness, and women's rights.
Purpose of the Study:
- Critically evaluate claims supporting planned home birth.
- Define appropriate professional responses for obstetricians.
Main Methods:
- Analysis of patient safety data for planned home birth.
- Evaluation of patient satisfaction and cost-effectiveness claims.
- Review of professional responsibilities and ethical considerations.
Main Results:
- Planned home birth presents unnecessary, preventable risks to pregnant individuals, fetuses, and neonates.
- High rates of emergency transport compromise safety and satisfaction.
- Claims of cost-effectiveness are undermined by comprehensive analysis.
Conclusions:
- Obstetricians should advise against planned home birth, addressing root causes for its resurgence.
- Physicians should refuse participation but provide emergency care for transported patients.
- Advocate for safe, hospital-based alternatives offering a home-like experience.
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