Serious mortality risk at home

AsiaOne: The Health Ministry does not support or encourage women to give birth at home, on their own, because the risk of complications is high. It may cause serious morbidity or even mortality to a mother, her newborn, or both.
Deputy Health Minister Datuk Rosnah Abdul Rashid Shirlin said the ministry acknowledged that women had the right to choose how and where to deliver, "but they don't have the right to put their baby at risk".
"Every pregnancy is a risk and the complications peak during labour and the immediate period after delivery," said Rosnah.
"Uncomplicated births can still potentially become a medical emergency without warning.
But the ministry is aware that there are women, who would prefer more natural, gentle, birthing methods, as opposed to what has benn perceived as an over-medicalised one in a hospital setting.
"We are aware and respect such preferences. We are continuously trying to accommodate such patients and their families' request," said Rosnah.
But such pregnant women are required to have had regular antenatal care and to have been fit throughout their pregnancy. A trained birth attendant would need to be present to assist.
The place of delivery would need to be safe and clean, with a reliable supply of clean water, electricity, good lighting and ventilation.
"The mother must inform her health-care provider (of her decision), who will then assess the safety of the home environment and advise the mother and her spouse or family, on things to prepare for the delivery," said Rosnah.
During the early stages of labour, the spouse or family must call the trained birth attendant to be present, who will then assist in the delivery.
"The trained birth attendant will be able to identify early warning signs of complications. The mother, spouse and family must understand and accept that if complications were to arise -- she will be transferred to a hospital."
In Malaysia, there is a law -- (Part V of the Midwives Act 1966 (revised - 1990) -- to ensure the safety of a mother during childbirth: a trained birth attendant must be in attendance during the delivery.
In Malaysia, this means registered midwives as they are the ones allowed to attend to births here.
Rosnah also pointed out that Malaysia's statistics showed that the risk of dying was much higher for a pregnant woman and her newborn if she were to deliver at home, rather than at a hospital.