AAP issues home-birthing guidelines

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The American Academy of Pediatrics (AAP) has issued new guidelines for mothers who want to give birth at home, in a controversial effort to make sure those who opt for home birth, do it in the safest way possible.

The AAP claims they had no choice but to issue recommendation on standards as the rise in home birth popularity continues. According to NBC News, home births have risen almost 30 percent in recent years, mostly among middle and upper class white women.

The new AAP guidelines recommends that home-birthing moms or parents adhere to the same standards of care that a hospital would offer. The AAP asks home-birthing moms to have assigned care managers for both mom and the baby, as complications with both patients can happen at the same time. They also recommend that newborns have their blood tested for genetic abnormalities and some for blood sugar rates immediately after delivery.

AAP acknowledges home birth rates rising, issues new guidelines. Photo via Ben Earwicker, Garrison Photography, Boise ID.

AAP acknowledges home birth rates rising, issues new guidelines. Photo via Ben Earwicker, Garrison Photography, Boise ID.

The AAP also recommends that a plan B be established and that the home birth be attended by a certified midwife.

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While the AAP says they still take the position that hospitals are the safest place to deliver a baby, they say they respect women’s right to choose home-birthing as an option for low risk deliveries. The AAP says that denying a woman that right doesn’t ensure the safest environment if they’re going to do it anyway, without having some guidelines to go by.

The new policy guidelines aren’t without its share of controversy however. Some doctors are arguing that the guidelines send the wrong message and bless home-birthing as a viable option when it’s not.

Dr. Amy Tuteur, MD, author of the blog “The Skeptical OB“, says of home-birthing, “[A]ll the existing scientific evidence and all national statistics indicate that homebirth triples the rate of neonatal death. Even studies that claim to show that homebirth is as safe as hospital birth, like the Johnson and Daviss BMJ 2005 study, ACTUALLY show that homebirth with a CPM has triple the rate of neonatal mortality of comparable risk women who delivered in the hospital in the same year.”

Likewise, Dr. Sindhu Srinivas, director of obstetrical services at the Hospital of the University of Pennsylvania and a professor of maternal-fetal medicine at the Perelman School of Medicine at the University of Pennsylvania told NBC that the unforeseeable issues and possible complications of child birth are the situations where giving birth in a hospitals can make the difference between life and death.

Dr. Srinivas said that in some rare cases, a woman can bleed out quickly if she starts to hemorrhage, potentially resulting in death within minutes.

The Midwives Alliance of North America (MANA) is applauding the new guidelines however, saying that the guidelines standardize care and give women care expectations at home.

Melissa Cheyney, MANA chair and practicing midwife said, “It’s clear that [AAP] supports birth centers and hospitals, but they also acknowledge that home birth is on the rise and they state that if a woman chooses homebirth, this is the standard of care she should expect.”

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