Meghan Markle, the Duchess of Sussex, gave birth this morning to a 7-pound, 3-ounce boy.
She planned to deliver her child at her new home in Windsor. However, she was a week past due and some British news outlets have reported that she was whisked away on Sunday for a hospital delivery to ensure the safety of both mom and baby.
These potential complications is one of the reasons why home birth is rare in the United States — fewer than one in 100 American mothers have their baby at home — but pregnant women often ask D. Ashley Hill, MD, how safe it is. He’s the medical director of AdventHealth obstetrics and gynecology who has delivered more than 7,000 babies.
Where and how to give birth is a complicated series of choices, and the decision is ultimately up to the mother. That said, a hospital is the safest setting for a birth, he says.
“I often hear moms say they want to do everything possible they can to protect their baby,” Dr. Hill says, “and if that’s the case, the evidence seems to point away from home deliveries.”
Babies born at home in the United States have higher rates of infant mortality and other serious complications.
In an April 2017 statement, the American College of Obstetricians and Gynecologists wrote, “hospitals and accredited birth centers are the safest settings for birth.”
At the same time, women who ask about home birth have valid concerns about how they’ll be treated in the hospital and whether their decisions will be respected. Advocating a hospital birth comes with the responsibility to honor a woman’s autonomy.
“We try to create as home-like an environment as we can and work with patients to customize their birth process to give them the experience they want and still make it safe for mom and baby,” Dr. Hill says.
What Does the Evidence Say?
According to the American College of Obstetricians and Gynecologists, about 3.9 in 1,000 babies born at home die within the first month of life. That’s compared with a rate of about 1.8 in 1,000 for hospital births.
It’s important to note this means the vast majority of babies born at home do not suffer for it. But the risks are higher at home, particularly for the baby.
“I’m very comfortable telling low-risk patients on their second or third baby that home birth may be a bit safer for them, but I’m also ethically obligated to say it’s more dangerous for the baby,” Dr. Hill says.
Furthermore, many women who try to give birth at home ultimately need the services of a hospital. One study in the Netherlands found that up to 40 percent of women who attempted home births ended up delivering in a hospital.
A hospital can provide services and technology generally not available at home, including equipment that:
- Measures the baby’s oxygen and, if necessary, provides extra to them
- Helps the baby breathe
- Removes extra fluid from their lungs
- Resuscitates them
There are some conditions under which a home birth is considered to be too dangerous to attempt, including when there is:
- A baby who is not positioned to come down the birth canal headfirst
- A mother who has had a previous C-section
- A problem with the placenta that could increase the risk of bleeding
- A multiple birth
This medical evidence has limitations. It’s been compiled by comparing the outcomes of women who give birth at home and those who do so at a hospital.
But unrelated differences between these groups of women — about a quarter of home births are unplanned, for example, which could carry additional risks — could be contributing to higher home birth mortality.
By trying to have a home birth, Markle was probably trying to tailor her birth experience. That’s a normal desire, Dr. Hill says, and one that is increasingly being accommodated inside hospitals.
Finding Control — at the Hospital
Pregnant women often consider a home birth for valid reasons, Dr. Hill says.
“It may be because they felt like they didn’t have control at a previous hospital or weren’t listened to,” he says. “I get that.”
At AdventHealth for Women, a Birth Experience Team works with mothers to create the kind of delivery a mom wants. You may also want to add a doula (a woman who gives support and guidance to a pregnant woman during labor) or midwife to your birth team.
Dr. Hill recommends that moms-to-be tour AdventHealth for Women to see for themselves how family-friendly and modern labor units have become. We offer the peace of mind that comes with giving birth at a state-of-the-art hospital with the latest technology and well-trained staff.
To learn more about the maternity experience at AdventHealth for Women, please visit our site or call Call407-303-4HER.