Push for a home birth at your own risk

CHENNAI: As a State well-known for its public healthcare system, Tamil Nadu is now facing a resurgence of an old problem: home births. The number of home births is increasing, thanks to videos of self-administered home births popular on social media platforms.

The news of a couple from Pudukkottai choosing a home birth for delivery of their second child, sans any medical support, has raised several concerns. Their decision comes after their first child died of a brain tumour three months after it was born in the Government Hospital at Aranthangi.

The couple had not registered the pregnancy with a village health nurse, and the pregnant woman did not undergo any medical examination during pregnancy. Upon labour, the husband opted for home birth based on the information he gathered through YouTube but the child died after an hour of being born.

This is not an isolated case. There are many families that choose home births after watching videos and reading messages on social media platforms, said doctors. There are WhatsApp groups that advocate home births.

Home births remain a challenge for the officials of the State Health Department officials as many individuals and natural medicine advocates emphasise on it, as a right of a pregnant woman. Though the health department aims at zero maternal mortality it has no provision to take action against home births.

While around 99.9% deliveries in the State are institutional, authorities have taken note of the rise in the number of home births. Myths and misinformation are some of the reasons for women and/or their families to choose home birth.

The latest concern are self-proclaimed life coaches and health experts who advocate natural birth at home and give examples of the delivery procedures being performed some decades ago. Consultant obstetrician and gynaecologist Dr Arvindh Santhosh opines: “It’s dangerous to believe everything you see, read and consume over social media. Not everything is factual. None of these so-called experts and coaches show the risk and complications of home births. The misinformation on such issues can increase maternal mortality rate. People advocating home births say that their ancestors delivered at home but they don’t remember the number of children our grandmothers had lost during and post deliveries. That’s why online content over such topics must be regulated.”

In addition to genetics and other healthcare parameters, a surge in non-communicable diseases in the last few years has raised the risk in home births.

Social media messages that advocate home births make it look like delivering a baby at home without medical help is easy. “You have to be trained in delivering a baby. While home births are being projected as a fundamental right, the yet-to-be-born baby also has a right to live. You’re putting your baby’s life at risk, and that’s unacceptable,” said Dr GR Ravindranath, general secretary, Doctors’ Association for Social Equality. “A lot of young women are not given the choice of hospital or the treatment they want for their baby. Their husbands and family members decide and opt for home births, putting the life of the mother and the baby at risk.”

Village Health Nurses also face the wrath of such misinformation and myths when they try to convince and educate couples to register the pregnancy and opt for institutional deliveries. “In addition to being influenced by decisions taken by their families and relatives, there’s also a legitimate fear among pregnant women that hospitals would insist on a caesarean delivery to make money,” Rajesh Selvaraj, general secretary, Tamil Nadu Government Nurses Association. “Also, many who choose home births don’t know that the maternal mortality rate was very high around 20-30 years ago.”

Concurring with him was Dr TS Selvavinayagam, Director of Public Health and Preventive Medicine, who added that the safety of the mother and the baby cannot be the responsibility of policymakers alone. It should be a priority for parents and family too.

“There is a difference between natural births and home births. While any delivery comes with certain risks, a medical institution is equipped to handle any complications,” he added. “People can only be advised to choose safety but there is no law prohibiting home births. In case a complication arises at home, there’s nobody medically trained or qualified to address it or surgically fix it. That’s why couples should at least let us reach out to them.”