Home birth is not an unusual occurrence for certain areas in our country. It has been practiced by traditional midwives and untrained birth attendants for many decades, since before the existence of modern medical facilities and hospitals. However by improving our health care system for pregnant women, it has managed to reduce catastrophic complications that lead to maternal and perinatal death.
Why then are there still a few women keen for home birth although they have access to local area hospitals? Surprisingly the majority of these women are those with a formal education. This however does not include those who deliver at home due to unbooked or unwanted pregnancies. There could be a few reasons why:
Feeling of self control and more satisfaction with home birth
Religious belief that requires only female birth attendants
To avoid unnecessary intervention such as instrumental delivery or caesarean section
More natural birth experience, without involvement of drugs or analgesia
In certain countries such as the United Kingdom (UK), home birth is allowed for low risk pregnancies after proper counseling during their antenatal follow up. Home births are one of their norms as the number of the trained midwives is more than enough to take care of pregnant women in certain areas. Good access to communication services, short distances to area hospitals and experienced midwives who have received accreditation from the Midwifery Colleges in the UK make this service applicable to their area.
“Last time, all our grandmothers delivered normally in the village. There was no need to go to a hospital”
That was one of the common statements heard, especially from older members of the population. Well, I would say that is true but bear in mind there was a higher rate of death among mothers and babies during deliveries. Most of them were not reported at the time and hidden from us. Children with disability were born due to unknown brain injuries or lack of oxygen during deliveries.
So, is Malaysia is ready for home birth services? In my opinion, not yet. There are a lot of things that need to be improved before it can be implemented in our country.
Post partum hemorrhage or massive bleeding after delivery is still the most common cause of maternal death around the world and we are trying to reduce this incidence. Some maternal deaths in rural areas due to this problem are still under reported.
Our traditional midwives are not well equipped with certain instruments and training to handle emergency or life threatening situations. Nowadays, traditional midwives are being trained by health care personnel and they are labeled trained birth attendants but they still require more training and accreditation before being able to work independently. However, they recognize their own limitation and when to refer urgently to the hospital.
The government is building more district hospitals and clinics in rural areas for better access to health...