Home birth ‘like your child not wearing a car seatbelt’

WOMEN who choose to give birth at home are taking the same risk with their child's health as driving them without a seatbelt, experts claim.

They argue that the danger of long-term disability in the event of complications during home births has been underestimated. In a paper published in the Journal of Medical Ethics, they say the "avoidable, foreseeable disability" that could be caused by delays in access to emergency care for newborns should "weigh heavily" on parents' decision about whether to give birth at home.

Home births are widely considered a mainstream option around the world for low-risk women, arguing that they can make birth more comfortable and save government health systems money.

However, leading Australian specialist Dr Lachlan de Crespigny and Oxford University ethicist Professor Julian Savulescu said that, while most women will deliver at home without complications, in the event of an emergency it was far safer to be in a hospital.

They said that the risk of long-term disability had not been "adequately addressed" by the medical literature on the safety of home births.

"Having a home birth may be like not putting your child's car seat belt on," they write.

"The risk of being injured in a single trip by not wearing a seat belt is extremely low. Still, we expect people to wear a seatbelt to make the risks as low as possible, despite some inconvenience and diminution of driving pleasure."

They cited a study from the Netherlands which found that when travel time from home to hospital is more than 20 minutes, there is an increased risk of the baby dying or suffering a long-term condition and other studies which showed that delays in accessing emergency care increased risks of brain damage.

While defending a mother's "absolute right" to choose where they give birth, Dr de Crespigny and Professor Savulescu nonetheless argue that health professionals "should not support home birth when there are safe and compassionate hospital-based alternatives."

Responding to the paper last night, the Britain's National Childbirth Trust (NCT) maintained that planned home births were as safe as hospital births for low-risk women in their second pregnancy.

Elizabeth Duff, senior policy adviser, said home births should be a "mainstream" option for women with a "straightforward pregnancy" but that for those who had suffered complications in a previous pregnancy, "a hospital may be the preferred choice".

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