Home birth, a practice authorized but not encouraged

The case has caused quite a stir on social media. A couple from Vitré, in Ille-et-Vilaine, had their two daughters taken away from them, one of them two years old and the second who had just been born and was barely a few days old.

This child had been delivered by the mother at her home, without any medical presence. Other elements, in addition to this unassisted home birth, prompted the authorities to proceed with the placement of the two girls, despite the challenges of the parents.

Home birth, an authorized practice but far from being encouraged

In principle, nothing prohibits a woman from giving birth alone at home. “But it is a practice that as a midwife, I advise against. Childbirth can take place in a birth center or at home, but imperatively in the presence of a midwife on the premises. First of all, says Géraldine Dahan Tarrasona, midwife, member of the Doctissimo committee of experts.

In addition to securing childbirth, she will be able to witness the birth. However, in the case of a childbirth without a witness, it is more difficult for a midwife to certify that the child is indeed that of the mother. “Underlying this is the whole issue of child trafficking, neonaticides… We cannot certify a birth if we have not seen it” explains the midwife again.

Limit the risks

If the presence of a midwife is more than recommended, it is for several reasons. First of all, as Géraldine Dahan Tarrasona reminds us, “some women will be excluded from the outset from this possibility of giving birth at home: those who have known health problems or those related to pregnancy such as hypertension or gestational diabetes, those whose fetus presents with a pathology, those who have obstetric problems…”.

In the end, only women in good health and with a physiological pregnancy will be able to claim this type of delivery, which represents the majority of deliveries. “In addition, each woman should be accompanied according to her wishes or in the closest way, if the medical context does not make it possible to respond completely.“emphasizes the midwife.”The main reason is to limit the risk of medical problems during childbirth which could turn into a tragedy.“adds the specialist.

Few midwives

In practice, if few women choose to give birth at home, few midwives offer this support service. “Midwives are faced with an insurance problem, they are asked for exorbitant sums and it is almost impossible for them to insure themselves” adds the expert.

More generally, the practice is not really encouraged by the health authorities, including via birthing centres, these structures where women can give birth in a poorly medicalized environment, but near a hospital. “We are late on the issue of birth centers in France. In Anglo-Saxon countries, this is done more without calling out,” says our expert.

Upstream work is needed

According to the National Institute of Statistics and Economic Studies (Insee), between 1980 and 2016, births outside the hospital represented between 0.5% and 1.9% of births with a very large majority of deliveries. “assisted”.

The Professional Association for Accompanied Home Childbirth has about 70 liberal midwives engaged in this practice. For the year 2020, there are 1,503 women who undertook a home birth process, including 223 who were finally referred to a maternity unit during pregnancy and 150 who started their home labor but had to be transferred before the birth of the child. “These births are in the minority, however, they must be coordinated in an optimal way between all the actors upstream, to redirect the women to the nearest maternity if necessary. Remember that the midwife is there to accompany the patient but that women must remain confident in their ability to give birth. concludes the midwife.