Is home birth illegal in Philippines?

In the past, most women gave birth to their babies at home. But with the coming of modern science, home birth is no longer promoted.

Instead, women are advised to give birth in hospitals or in birthing centers. Yet there are still women who prefer giving birth at home rather than in a hospital. This article will explore the reasons why women should not to choose home childbirth.

Is home birth illegal in the Philippines?

More than 500,000 women die each year due to causes associated to pregnancy worldwide. The majority of these fatalities—nearly 99 percent—occur in underdeveloped countries.

According to estimates, ten Filipino women die every day from birth-related issues, the majority of which can be prevented. Early in the 1990s, the maternal mortality ratio (MMR) in the Philippines was 209 (per 100,000 live births).

The Millennium Development Goals called for recording 52 fewer maternal deaths (MDG). The Philippines did not meet this MDG goal, but it is believed that MMR has stabilized at 172.

Approximately 60% of births in the Philippines take place at home. A facility-based delivery under the supervision of a licensed healthcare professional with access to emergency obstetric care is an excellent method for preventing maternal death.

What the Philippine government says about natural home birth

In an interview with Rappler, Zenaida Recidoro, program manager for the National Safe Motherhood Program says that the DOH does not forbid home births. The purpose of the order was to promote facility-based delivery alone.

The Department of Health has consistently debunked the idea of a “No Home Birthing Policy” (DOH). According to DOH officials, the government is “merely advocating and encouraging facility-based deliveries.”

The Maternal, Newborn and Child Health and Nutrition Strategy (MNCHN), also known as the “No Home Birthing” Policy, requires public facilities or local government units (LGUs) to raise money for birthing facility improvements, participate in other public-private partnerships, or accredit private facilities as providing Basic Emergency Obstetric and Newborn Care (BEmONC). 

In essence, it encourages mothers to give birth in privately or for-profit operated facilities because public ones are either understaffed or nonexistent.

The MNCHN manual of operations is backed by organizations that favor neoliberalism, such as the World Bank, the US Agency for International Development, and the Japan International Cooperation Agency.

The MNCHN approach was first described in Administrative Order 2008-0029 issued by President Arroyo. It was updated and published in the MNCHN Manual of Operations (MOP) in 2011 during the administration of President Aquino.

The MOP is quite specific about encouraging facility-based deliveries and forbidding deliveries supported by traditional birth attendants (TBA) (even by those educated by the government).

In order to investigate the fines levied against women and medical professionals, Gabriela submitted House Resolution 1531, a written resolution to the Philippine Congress, in 2014. The resolution questioned the ban on home births.

After it failed the first time, Gabriela re-filed it in 2016, but nobody ever brought it up.

Why do experts discourage home birth in the Philippines

Despite the fact that many women find the program to be burdensome, the administration is continuing with it. 

Obstetrician and gynecologist Dr. Agnes Bernabe says that every birth puts lives in danger. As a doctor, she is aware of the risks, so she won’t promote home births.

She works at the Nueva Vizcaya Provincial Hospital and a private clinic in Bambang as well as on the committee that investigates maternal mortality in the region.

She says that home deliveries and conventional treatments are the typical causes of mother and infant mortality (procedures carried out by a local healer after birth).

According to the Department of Health, complications during pregnancy, labor, and delivery as well as issues that arise after delivery are to blame for the majority of maternal deaths in the Philippines.

When the policy was implemented in 2008, slightly more than 50% of births in the Philippines took place at home. Only a small percentage of them receive traditional birth attendant assistance (who are not medically trained). There are no comparable numbers for midwives’ roles.

The strategy has reportedly helped mothers learn “more about the need of seeing a doctor and hospital deliveries nowadays,” according to Bernabe.

Natural home birth

Giving birth at home rather than at a hospital or birthing center is referred to as a “planned home birth.” You will still need the assistance of a competent and experienced individual throughout labor and delivery.

Most home births are attended by midwives or other birthing professionals.

If you’re considering having a child at home, consult your doctor first. They should explain what to expect throughout labor and delivery. They ought to talk to you about potential problems and how you might tackle them at home.

In order for you to be eligible for safe home delivery, the medical expert must be upfront and truthful with you about any potential risks. Also necessary is a clear justification of the circumstances under which they would suggest moving to a hospital.

Studies show that neonatal fatalities or significant injuries are more likely to occur with home births than in hospitals. Because of this, neither the American College of Obstetricians and Gynecologists (ACOG) nor the American Academy of Pediatrics (AAP) now support home birth.

Other substantial research on planned home deliveries, however, has found remarkably low rates of infant mortality.

Some of these findings, meanwhile, also relied on whether or not it was believed that the expectant mother was carrying a high- or low-risk pregnancy. With prepared home deliveries, low-risk women had a very high rate of healthy births. 

There is still a lot of debate surrounding the security of scheduled home deliveries. Before making a choice, you need to consider a number of factors.

When it is advised

Home birth is ideally encouraged for women with the following conditions. First of all the mother should have a healthy, low-risk pregnancy.

Another is that there is an availability of a trained and experienced birth attendant. Next is that the home birth should be well-planned. Lastly, a modern hospital is nearby so that the mother can be easily and quickly transferred in case of emergencies.

Benefits

The advantages that home birth can give to a mother are the following. First, she is in a familiar and relaxing environment with family and friends around when she gives birth.

Second, she is more in control of the birth because she can decide on the environment she wants. Third, she is free to make herself as comfortable as she wants. Fourth, she can enjoy the comforts of her home. Fifth, she is not subjected to potentially problematic medical interventions.

Sixth, she will have more attention, care, observation, and monitoring by a trained birth attendant. Seventh, she will feel more capable and confident as a mother after giving birth. Eighth, she will have immediate bonding with her baby.

Ninth, she will be able to breastfeed right after birth which is equally beneficial for her and for the baby. Finally, it is less expensive to give birth at home than to give birth in a hospital.

When it is not advised

On the other hand, home birth is not encouraged when:

(1) the mother has diabetes or high blood pressure;

(2) a trained and experienced home birth attendant is not available;

(3) the mother thinks she will not be able to stand the pain of labour and delivery;

(4) the mother experienced or is at risk of complications such as preterm labour, pre-eclampsia or a breech position of baby;

(5) the mother had a previous cesarean delivery or a uterine surgery; and

(6) the spouse is not supportive of home birth.

Home birth disadvantages

Before you decide to have a home birth, several drawbacks should be considered.

• If you cannot stand labor pains anymore, there is no option for an epidural.
• If complications such as exhaustion from labor, premature rupture of membranes, fetal distress, cord prolapse, or hemorrhage arise, you have to be transferred to a nearby hospital.
• You are held responsible for every decision or preparation for the homebirth.
• Lack of privacy due to the presence of family and friends may restrain the labor.
• Death is more probable to happen. 1-2 per 1,000 births at home result in infant mortality, which is at least twice as high as births in hospitals.
• During birth, there is a higher chance of brain injury and seizures. Home births had a 0.4–0.6 per 1,000 births rate of neurologic impairment, which is three times higher than hospital births.

Natural home birth safety

 Below are factors to be considered and preparations to be made to ensure safety:

1. Hire a certified nurse-midwife and an obstetrician with experience in home birth deliveries. Interview the prospective midwife who will assist you in the delivery. Get to know her and ask what you can do to cope with labor pains and other things you may need to know.
2. Prepare a backup plan. In case complications arise, you should have another plan to speed up your transfer to a nearby hospital.
3. Choose in advance a pediatrician to visit the baby within 24 hours after birth.  This is to ensure that the baby will not have any problems or complications.
4. Prepare the necessary equipment or materials for the procedure. Aside from the equipment that will be brought by the midwife or home birth attendant, you have to ask and prepare the other things that home birth will require.

To have a picture of what home birth is, watch this video about a woman’s options in giving birth at home or at a birthing center.

If you are pregnant and are considering a home birth delivery, make sure that you have weighed the pros and cons of this type of delivery.

No one else can decide what is best for you and for your baby. But your decision will definitely have an impact on your baby’s health and safety.

Who is eligible for a home birth

Here are conditions that are considered to be “low risk” and are good candidates for home deliveries.

• A pregnant woman who is expecting a single baby and has decided to give birth at home
• The infant is head down at term.
• At weeks 37, 41, and 42 of pregnancy 
• Pregnant women with no serious ailments such as heart disease, kidney disease, blood clotting disorders, type I diabetes, gestational diabetes managed with insulin, preeclampsia, or bleeding
• No placenta previa at the onset of early labor
• No genital herpes
• Absence of thick meconium
• No prior C-sections
• Unexpected labor

Not all women ought to give birth at home. A home birth necessitates a great deal of preparation, accountability, and involvement on the side of the parents.

Women who opt for a home birth must also be ready to labor without an epidural. But it is possible to change your mind during labor and move to the hospital for an epidural.

Home birth vs hospital birth

For many people, the advantages of a natural home birth may include:

• a comforting, familiar setting
• more control
• No requirement to use treatments or drugs.
• Greater likelihood of having a vaginal birth
• More personalized support and care than in a hospital
• high rate of exclusive breastfeeding
• lower cost
• considerations based on culture or religion

In some emergency cases, you’ll need to get to the hospital. Home births have been found to be most secure when they occur near a hospital. If you think you might need to visit the hospital, you should be prepared and have arrangements in place.

Not every woman can give birth at home safely. Find a medical professional who can clearly explain when home birth is a safe option for you and when they would suggest a hospital transfer. For many women, giving birth in a hospital is safer.

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