Home Delivery and it’s Benefits
Changes in the birthplace scenario
Until the end of the 19th century, births took place chiefly in the homes of pregnant women, who were attended by midwives and companions, often the female members of the family or the local community. However, with the advent of modern medicine, the institutionalization of childbirth in hospitalized environments has led to the use of interventions in a woman’s body to accelerate birth. Childbirth is no longer seen as a natural, physiological event, but centers on the figure of the doctor.
The institutionalized parturition process began towards the start of the Second World War onwards. Once fully instituted, it led to the incorporation of interventionist protocols into the hospital routine by most health professionals. The application of unnecessary medical procedures to parturients without their consent or right to understand the actual need for such interventions – which today constitute cases of obstetric violence due to physical and psychological trauma – are all a direct result of this phenomenon. Furthermore, the delivery itself has exclusively become the merit of the medical team, thereby robbing the woman of her protagonism in this unique moment.
Reclaiming the choice for home birth
The choice of home delivery is increasing among future mothers. The desire for women to assert control over their bodies; to make a [more humanized delivery] possible; to have their wishes respected, guaranteed protagonism, and the presence of a companion of her choice underscore the rapid popularization of feminist (ideas? thought?) in the recent years ;
The World Health Organization (WHO), as well as the International Federation of Gynecologists and Obstetricians (FIGO), recognize the right of women to choose the place of birth and the benefits of home birth when assisted by qualified professionals. In 1996, WHO published a document titled Care in Normal Birth: A Practical Guide: Report of a Technical Working Group, which presents recommendations based on scientific data on practices related to the least institutionalized childbirth possible, aiming to guarantee women’s rights, promote changes in the scenario of unnecessary interventions, questioning procedures performed without scientific or routine evidence. This report also contains guidelines on home birth and its advantages. In Brazil, these recommendations were published by the Ministry of Health in 2000.
Benefits of home birth
There are several key benefits to choosing home birth, with the correct planning and monitoring:
- a cozy environment for the parturient;
- Respect for the pregnant woman’s wishes;
- The guarantee of the woman’s protagonism;
- Freedom in the choice of companions;
- Reduced medical interventions;
- Freedom to choose positions;
- Freedom to choose therapeutic practices (music, essential oils, lighting, among others);
- Freedom to eat and hydrate;
- it favors dilation due to the parturient’s relaxation and delivery capacity;
- Reduced chances of infection by hospital bacteria (for the mother and baby).
Challenges to be faced
Although the option for home birth has grown in Brazil, the practice of surgical births is still prevalent among pregnant women, and the choice for this delivery method is mostly due to the lack of knowledge and convenience than due to actual need. According to more recent WHO studies, nearly 55% of deliveries in the country are via cesarean section; and within the remaining 45%, only 2% are households. Consequently, the discussion about a residential parturition process needs to occur, breaking with some taboos and myths, both among segments of society and in the health sector.
Another problem with home birth is its limited reach. Unfortunately, proper execution remains limited to an elitist party in Brazil; in peripheral or inland areas, it is customary to deliver at home, but with insufficient assistance, if any. Hence, activists and health agencies in Brazil discuss the recognition of home birth by SUS so that all women in the country have the right to choose this way of delivery.
It is noteworthy that, although this mode of delivery occurs in homes, it is still necessary to have some monitoring. The most highly regarded health agencies recommend that the responsible team be multidisciplinary and contain at least two professionals, which may vary (among or between?) a [Doula], an obstetric nurse, and an obstetrician. Thus, the safety of the mother and baby is guaranteed.