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Jennings: Emergency Care Can Be Too Urgently Needed for Home Births

New York TimesFebruary 24, 2015Articles, Hear from Our Doctors

When women decide where to give birth, they should understand the potential risks involved with their options, especially if they have underlying factors that increase risk of complications. A hospital or birthing center continues to be the safest place for labor and delivery; evidence shows that although the overall risk of serious childbirth complications remains low, there is still a twofold to threefold increased risk of neonatal death associated with home birth.

We must not forget that the life-threatening complications associated with labor and delivery can appear quickly. The ability of a physician and labor team to rapidly respond and provide emergency care can be the difference between life or death for both mother and baby. Certain complications, like postpartum hemorrhage, can be fatal within minutes.

As obstetrician-gynecologists, our goal with any delivery is a healthy mother and a healthy baby. We know all too well the potential tragedy associated with maternal complications during labor, and we want to spare families that level of loss.

That’s not to say that our healthcare system can’t do more for women as they approach childbirth. We can do a better job of bringing the comforts of home into a controlled birth setting, whether at a hospital’s labor and delivery unit or at hospital-affiliated birth centers. We can embrace team-based care and collaborate more readily with certified nurse-midwives. We can work with patients to create action plans that reflect a woman’s wishes for pain management, her birth advocates, and more.

But we must be prepared, if need be, to provide mother and baby with the medical interventions they need to survive and to thrive.

John Jennings is the president of the American Congress of Obstetricians and Gynecologists.

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