Most people who choose to have their baby at home are prepared for the
amount of responsibility a homebirth entails. However, there are some
general prerequisites and contraindications of a safe homebirth that
everyone should consider before making their final decision.
Definite Contraindications
The following conditions may cause serious problems, both for the
mother and the baby, and access to the emergency facilities in a hospital
might become crucial: Diabetes, thyroid disease (Hyperthyroidism),
chronic lung disease, severe asthma, epilepsy, clotting abnormalities,
congenital heart disease (grades 2-4), and kidney disease.
Other conditions may exist prior to conception, or may arise during
pregnancy: A homebirth would not be a healthy choice for someone with severe
anemia, acute viral infection (such as rubella, cytomegalovirus, or
chicken pox), unresolved venereal disease, hypertension, malnutrition,
drug and/or alcohol addiction, or who smokes heavily (more than 10
cigarettes a day).
Any woman exhibiting the symptoms of preeclampsia or toxemia should
also be referred to a physician. These symptoms include: extreme edema,
protein in the urine (proteinuria), headaches, vision disturbances,
hypertension, sudden & excessive weight gain. 1
Possible Contraindications
Some conditions may or may not cause problems, and need to be monitored
carefully via ultrasound, such as fibroids, which tend to grow
excessively large during pregnancy, and may impede the growth of the fetus
or the implantation of the placenta. Having undergone uterine surgery
such as procedures to the cervix (i.e.: cauterization, cryosurgery, or
cone biopsy) can cause considerable scar tissue and retard cervical
dilation during labor. 1
VBAC (Vaginal Birth After Cesarean)
At one point, it was commonly believed that if a woman had had a
cesarean birth, she would have to have a cesarean with all future births.
However, medical evidence has not borne this theory out, but instead has
proven that women who have had cesareans are perfectly capable of having a
vaginal delivery. In fact, a vaginal delivery is much healthier for both
mother and baby. Having a VBAC at home is every bit as safe as having one
anywhere else. People always wonder about the chance of uterine rupture:
it is as unlikely in a VBAC birth as in any other, and is more
catastrophic in an unscarred uterus! 2
Unforeseen Problems
There are times when everything has seemed picture perfect, and toward
the end of the pregnancy, something comes up that muddies the homebirth
plan. Like a breech or a transverse presentation. These situations must be
dealt with on an individual basis. Some parents are perfectly willing to
try a breech at home, providing their midwife has experience or training
delivering breeches. In a hospital setting, breeches almost always result
in cesarean delivery. Transverse presentations can often be turned before
labor begins. If the baby cannot be turned, the mother will have to have a
cesarean. Twins are another consideration. Again, the choice belongs to
the parents, what they feel comfortable with, and what their midwife is
capable of doing.
