AAP issues statement on home births

The American Academy of Pediatrics has issued a new policy statement with recommendations for the care of infants born in the home setting.

The AAP stated it concurs with the recent statement from the American College of Obstetricians and Gynecologists that the safest setting for a child’s birth is a hospital or birthing center, but recognizes that women and their families may desire a home birth for a variety of reasons. Regardless of the circumstances of the birth, including location, every newborn infant deserves healthcare that adheres to AAP standards, according to the statement.

Pediatricians should advise parents who are planning a home birth that the AAP and ACOG recommend only midwives who are certified by the American Midwifery Certification Board.

There should be at least one person present at the delivery whose primary responsibility is the care of the newborn infant and who has the appropriate training, skills and equipment to perform a full resuscitation of the infant.

All medical equipment and the telephone should be tested before the delivery, and the weather should be monitored. A previous arrangement needs to be made with a medical facility to ensure a safe and timely transport in the event of an emergency.

AAP guidelines include warming; a detailed physical exam; monitoring of temperature, heart and respiratory rates; eye prophylaxis; vitamin K administration; hepatitis B immunization; feeding assessment; hyperbilirubinemia screening; and other newborn screening tests. If warranted, infants may also require monitoring for group B streptococcal disease and glucose screening.

Comprehensive documentation and follow-up with the child’s primary healthcare provider is essential, according to the statement, which will be published in the May issue of the journal Pediatrics.

Download a PDF of the policy statement: http://pediatrics.aappublications.org/content/early/2013/04/24/peds.2013-0575.

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