(live here) – In recent years, there has been a growing trend of women choosing to give birth at home, in a comfortable and familiar environment. Although most home births end well, sometimes things go wrong and complications arise that can also occur in a hospital, where the rapid response of the medical team and advanced medical equipment are available. These can make the difference between a birth that ends happily and peacefully, and one that turns into a tragedy.
To understand the risks involved in home birth and to examine whether this choice is the right one, we spoke with Noga Bishop – a nurse in charge of the Women's Health Center at Lynn Medical Center (Clalit Health Services), a certified midwife, a bachelor's degree in nursing, a graduate of a course on fertility, and an experienced clinical instructor.
"Childbirth is a physiological process that in most cases ends without complications," says Bishop. "Studies show that a planned home birth, for healthy women with low-risk pregnancies, carried out in accordance with Ministry of Health procedures and accompanied by a certified midwife or obstetrician, does not involve any more risks than a hospital birth."
Comparing home birth to hospital birth, Bishop explains that hospital birth takes place in a medical environment with a multidisciplinary team, which ensures immediate availability of medical care if needed, but limits the number of companions in the delivery room. In contrast, in a home birth, the environment is more intimate and familiar, with the mother being accompanied by a midwife she knew during the pregnancy and who performed close monitoring, which reinforces the sense of security and creates a relationship of trust. In addition, in a home birth, medical intervention is usually minimal, which allows for a more natural management of the process.
What risks or complications may arise during a home birth? How are they different, if at all, from those that may occur in a hospital?
"The possible complications of home birth and hospital birth may be similar and include lack of progress in labor, fetal distress, amniotic fluid aspiration, lacerations, increased bleeding, and more. However, in home birth, it is important to ensure that it is carried out under the supervision of a qualified midwife, who is skilled in early identification of complications or dangers, which can prevent deterioration of the condition and maintain the health of the mother and baby."
In the hospital, on the other hand, there is immediate availability of a multidisciplinary team including midwives, nurses, obstetricians and pediatricians, allowing for rapid and focused care. In the event of serious complications requiring critical intervention within minutes, the hospital's staff and medical equipment can make the difference between a positive outcome and significant risk."
Why, in your opinion and from your professional experience, are more and more women choosing to give birth at home?
"For many women, childbirth is a special and exciting event – a truly miraculous moment. Beyond being a physiological process, it is an empowering emotional experience that has deep meaning, one that will be remembered by the couple throughout their lives. Giving birth in a calm and familiar environment, within the bosom of close family, gives the mother a sense of control, freedom of choice, and peace of mind, which contribute to shaping a more positive, intimate, and meaningful experience."
"The decision of where to give birth is a personal one, and it is very important to carefully consider all the pros and cons before making the final decision," says Bishop in response to a question about her recommendations for those who nevertheless decide to give birth at home. "I recommend consulting with a certified gynecologist and midwife, who can provide professional information and support the most appropriate decision for the mother and baby. In addition, it is recommended to take a tour of a hospital delivery room, in order to become familiar with the medical options and technologies available and compare them to the home environment. This way, a more informed and balanced decision can be made, taking into account the needs and possible risks."
How can a mother feel more "at home" during a hospital birth? Is it possible to request adjustments in advance that will make the experience easier?
"Today, all delivery rooms in hospitals in Israel offer a personalized birth experience, with the mother receiving the option of a natural birth without unnecessary medical intervention, but only with her consent. The hospitals offer natural means of pain relief alongside complementary medicine.
In the delivery room at Carmel Hospital, it is possible to talk to the midwife and coordinate expectations before birth, which helps create a more personalized and pleasant experience. There is also the option of personalized emotional accompaniment – WOMEN FRIENDLY – by a midwife who has been certified for this purpose. After birth, there is the option of zero separation between mother and newborn from the moment of birth, which promotes a quick and natural connection between mother and baby. A motel adjacent to Carmel Hospital for women after childbirth is expected to open soon, offering recovery in a homely atmosphere accompanied by a trained professional team.
Why is it important and more effective to give birth in a hospital?
"It is very important to give birth in a hospital because there are complications that may develop quickly and become life-threatening. In such situations, immediate medical intervention is needed that is not always possible to provide in the limited conditions of home. In hospitals, there is a high availability of skilled medical staff and advanced medical facilities, which ensures the safety of the mother and newborn and allows for quick and effective treatment of unexpected complications."
Are there women in risk groups for complicated birth?
"Regarding women in risk groups for complicated births, there are conditions such as gestational diabetes or a high-birth-weight fetus, in which the risk of complicated births is higher, and it is important to exercise caution in choosing the location and accompaniment during birth."
In the event of a complication during a home birth, God forbid, what is recommended to be done?
"In the unlikely event of a complication during a home birth, you should make sure to get to the nearest hospital quickly in order to receive immediate and professional treatment."
In conclusion, Bishop says that at the Clalit Women's Health Center, pregnant women receive professional, sensitive and empathetic support throughout their pregnancy and after birth. "The approach at Clalit is that hospital birth is safer for the mother and baby, thanks to the immediate availability of medical care and a wide range of possible interventions, if necessary. Today, delivery rooms offer a wide range of options for the mother and emotional change, as the mother is given conditions that allow her to give birth in the way she chooses, while maintaining her own safety and that of the baby."
An excellent article that explains the magnitude of the responsibility and risks involved in childbirth, and the advantage that a hospital provides.