Should home births be turned into reality TV?

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Lifetime has an unscripted series, Born in the Wild, which documents couples’ decisions to forgo birth in a hospital and instead give birth in nature on their own terms without assistance:

In this new series, families take one step beyond home birth and make the powerful choice to experience childbirth in the great outdoors. No inductions, no epidurals … just expectant mothers facing and giving birth in the arms of Mother Nature. They’ll take on the unique challenges of their natural environment, tackling every obstacle the wilderness can dish out in order to realize their dream of an outdoor birth.

On the surface, this seems like any other new reality series with a surefire formula to score big ratings based on the shock value alone. However, more people are turning toward home births or freestanding birthing centers not affiliated with hospitals. All of the participants of the TV series apparently had an unsatisfactory birthing experience in a hospital setting during a prior delivery and are hoping for a more satisfying experience “in the wild.” Not only are these show participants deciding not to have their deliveries attended by medical staff, they are purposely going out in the middle of nowhere to do it.

We already know birthing at home can inherently have more dangers based purely on the location of the delivery. Data presented at the 2014 Society for Maternal-Fetal Medicine’s annual meeting by researchers from New York-Presbyterian/Weill Cornell Medical Center demonstrated that the risk of a baby dying is nearly four times higher when delivered by a midwife at home than by a midwife in a hospital. The risk jumps sevenfold for a first-time mother and tenfold in pregnancies over 41 weeks. Yet there is a growing push toward labor and delivery experiences being “more natural” and for providers not to “medicalize” the process of childbirth. Just ask any obstetrician about the complexity and variety of birthing plans they encounter on a daily basis.

While perhaps more picturesque and accommodating, home (or “in the wild”) births do not have the advantages of a hospital delivery, most notably access to immediate critical care. In a separate 2014 study published by the Midwives Alliance of North America (MANA) in the Journal of Midwifery and Women’s Health, home birth mothers had a lower rate of C-sections, labor interventions (such as episiotomies, medication for augmentation, etc.), and epidural analgesia. Remember that about a century ago, roughly 600 American women died during childbirth per every 100,000 live births. Thankfully, modern medicine has brought this number down to about 15 per every 100,000. Also, let’s not forget that outside of a hospital setting, there is no access to a neonatologist, respiratory therapist, supplemental oxygen, blood and blood products, emergency “code” drugs, fetal monitors, or antibiotics.

Lifetime apparently is taking its own precautions (and can you even imagine the liability?) to ensure the safety of both mother and child. No first-time mothers will be allowed to participate on the show, and all participants must “have a clean bill of health.” The pregnancy must be considered low-risk. A trained emergency professional will be on site. While the couple ultimately does choose the birthing location, the production will remain within a certain radius of a hospital should complications arise (not that the casual viewer will even notice).

Note: The American Congress of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) have both endorsed hospitals and birthing centers as the safest places to deliver a baby but respect the rights of a woman to make an informed decision about delivery.

Justin Morgan is a pediatrician who blogs at Bundoo, where this article originally appeared.  He can be reached at his self-titled site, Justin Morgan, MD.

Image credit: Shutterstock.com

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