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Pediatrician Group Issues Home Birth Policy Statement
Date:4/29/2013

f neonatal death. "We need better research," said Watterberg.

However, because the rate of home births is increasing, and because the academy wants to provide a "professional, supportive interaction" with expectant mothers, Watterberg said the group developed its new policy. The AAP recommends the following factors for a mother considering a home delivery:

  • Absence of preexisting medical conditions,
  • Absence of significant disease during pregnancy,
  • A singleton pregnancy (no twins, triplets or higher),
  • Baby's head is facing down,
  • Pregnancy has lasted at least 37 weeks, but no more than 41 weeks,
  • Spontaneous labor, or labor induced as an outpatient,
  • A certified nurse-midwife, certified midwife or a physician practicing within an integrated and regulated health system,
  • At least one appropriately trained person whose primary responsibility is the baby (this person must be qualified to resuscitate the baby if necessary),
  • Ready access to consultation,
  • Assurance of safe and timely transport to a nearby hospital with a preexisting arrangement for such transfers.

Watterberg said midwives often work in teams, and one can be responsible for the baby's care after birth.

"It's important to remember that this is an area of strong emotion. You'll see babies in home births have terrible things happen, but you also have terrible things happen in the hospital sometimes. Women have the right to make an informed decision," she said.

And, if a woman chooses home birth, Watterberg said it's important for the expectant mother to meet the person who will care for her baby after birth. "Meet with that person beforehand. Talk with them about your plans, and see if they have anything to add," she advised.

Dr. Peter Bernstein is a maternal-fetal medicine specialist and director of the perinatal safety program at Montefiore Medical Center in New York City. H
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