U.S. pediatricians issued new guidelines Monday for home births, requiring the presence of two people at such deliveries: one person responsible for the mother and one for the baby.
The primary function of the baby’s caregiver would be to resusitate a newborn infant who experiences breathing diffulties, according to the rules being offered by the American Academy of Pediatrics.
The safety of home birth has become a hotly debated issue, particuarly among the doctors whose services typically are not used in such settings. Home deliveries tend to be overseen by specially trained nurse midwives.
The Texas Department of State Health Services requires midwifery students to have a high school diploma or GED certificate, and current certification in infant and adult cardiopulmonary resuscitation. Under state law, a licensed midwife can assist only in normal home deliveries and does not administer a prescription drug except as an agent of a physician licensed by the state. (Certified nurse midwives are regulated by the Texas Board of Nursing.)
The new standard for home deliveries concurs with a recent statement from the American College of Obstretricians and Gynecologists. Obstetricians are the doctors who deliver babies in hospitals and birthing centers.
The pediatricians’ new rules noted the growing popularity of home births among some American women.
“Although the incidence of home birth remains below 1 percent of all
births in the United States, the rate of home birth has increased during
the past several years for white, non-Hispanic women,” the report noted.
A spokesperson for the Association of Texas Midwives said she had not read the pediatricians’ recommendations for home delivery. However, a number of the suggested practicies already exist in Texas.
“I do not know any licensed midwife who would attend a birth alone by choice,” said Claudine Crews, course coordinator for the association’s Midwifery Training Program.
“It is already the norm to have at least one person present whose responsibility is the immediate care and assessment of the newborn. And, neonatal resuscitation certification is a requirement for licensure in Texas,” she said Monday by e-mail.
The Guidelines for Perinatal Care also called for “provision of warmth, initiation of appropriate resuscitation measures,and assignment of Apgar scores. Although skin-to-skin contact with mother is the most effective way to provide warmth, portable warming pads should be available in case a newborn infant requires resuscitation and cannot be placed on the mother’s
Crews said she had not surveyed other midwives to determine if warming pads were considered standard equipment. “But I know I carry two heating pads with me to every birth,” she said.