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What are the risks for birth injury in at-home births?

The American College of Obstetricians and Gynecologists (ACOG) maintains that the safest place to deliver a baby is in a hospital, but planned home births are on the rise. In the U.S. 1 out of every 62 births in 2017 occurred outside of the hospital. But how safe is it to deliver at home?

Some women tell emotionally powerful stories of giving birth in their living rooms. The reality is that not every pregnancy is eligible for a home birth and you must consider the serious risks and costs before you decide the best option for you.

Who is responsible during a home birth?

Unlike hospital births, planned home births are typically supervised by a midwife and/or doula. A midwife is a medical practitioner who delivers babies. Unlike most states, Iowa does not have legislation supporting their practice. Lawmakers introduced a bill to correct this in 2017, but its status is unclear.

Doulas are more psychological counselors you can hire to guide you through the birthing process at home or in a hospital. They can be your medical advocate in a hospital and help with simple tasks around the home during and after birth. They usually have agencies organized by location.

What are the calculated risks?

Only low-risk pregnancies are eligible for home births. Women with high blood pressure, diabetes, carrying twins, or experiencing breech births cannot give birth at home.

If a woman chooses a home birth she should take as many precautions as possible. Delayed care for mother or child due to distance from hospital alone increased the risk for long-term injury. Home birth is associated with the following risks:

  • Doubled risk of death in childbirth
  • Tripled risk of neurological dysfunctions during birth

It is also important to note that at-home births are not covered by most insurance policies. Most expenses will be out-of-pocket. This limits many women's ability to choose a home birth.

Data on home births is limited and difficult to calculate. However, all medical authorities agree that having a licensed medical practitioner present at a birth helps to lower the risk for preventable deaths or injuries.

Until laws exist in Iowa to support midwives, mothers and babies are at an increased risk for birth injury at home or in the hospital. If something should happen during a home birth, it could be a complicated legal situation. 

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Hixson & Brown, P.C.
160 South 68th Street
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West Des Moines, IA 50266

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