From the Research
The patient should be informed that hospital births are the recommended setting for delivery due to the potential risks associated with out-of-hospital births, including increased rates of avoidable adverse perinatal outcomes, as evidenced by a recent study published in the American Journal of Obstetrics and Gynecology 1.
Key Points to Discuss with the Patient
- The patient's desire for a home birth should be acknowledged, and information about the potential risks and benefits of different birth settings should be provided.
- Hospital settings offer immediate access to emergency interventions if complications arise during labor or delivery, which can be life-saving for both mother and baby.
- While home births can provide a more comfortable and personalized experience, they are generally recommended only for low-risk pregnancies.
- A balanced discussion should include that while cesarean rates may be higher in hospitals, this often reflects appropriate medical interventions for high-risk situations.
- The patient should be encouraged to consider a compromise, such as a birthing center or a hospital with midwifery services that can provide a more home-like environment while maintaining access to medical care if needed.
Prioritizing the Patient's Safety and Preferences
The healthcare provider should respect the patient's autonomy in decision-making while ensuring she has complete information about the potential risks and benefits of her choices. This approach allows for shared decision-making that prioritizes both the patient's preferences and the safety of mother and baby. According to the study published in the American Journal of Obstetrics and Gynecology 1, out-of-hospital births are associated with increased rates of avoidable adverse perinatal outcomes, including neonatal mortality rates that are significantly elevated for all planned home births.