The health center “Stork’s Nest”, under the supervision of which the mother died, has been offering home birth services for years and believes that it is safe to give birth outside the hospital. At the Riga Maternity Hospital, on the other hand, there is a lot of risk when giving birth outside the hospital, and each mother must carefully evaluate them.
Tragic births, in which a mother died at the end of July on the Jelgava side, a planned home birth. This means that professional midwives also took part. What happened has become the basis for a discussion – whether it would have been possible to save a woman if the birth had taken place not at home, but in a hospital.
In recent years, the mortality rate among mothers in Latvia has been wavy. Between one and 12 mothers die each year during childbirth or postpartum, as was the case in 2015.
The home birth in Jelgava took place under the supervision of the health center “Stork’s Nest”. For 15 years, the center has been offering children outside the hospital.
“This is the first case of a planned outpatient birth,” emphasizes Reinis Ceplis, a member of the board of Stork’s Nest, noting that it is safe to give birth outside the home under the supervision of specialists.
Planned home births have been regulated since 2006 by regulations of the Cabinet of Ministers, which describe in detail in which cases, under the supervision of which equipment and specialists home births are allowed. Such a service is offered by several medical centers. And every year from 250 to about 300 planned home births take place in Latvia. This is just over 1% of the total number of births.
“Pregnant women are cared for before giving birth, their condition is assessed. A maternity contract is signed with them only if there are no preconditions why it could not be done. And these conditions are defined in the same 611 rules, but we also have our own stricter assessment procedures. , because it ‘s about human safety, “says Reinis Ceplis, a member of the board of” Stork’s Nest “.
The safety aspects are also emphasized by the specialists of the Riga Maternity Hospital. About a third of newborns in Latvia come into the world here. Doctors point out that during childbirth there are also possible unforeseen problems, which can be eliminated only in the hospital. For example, in about 2% of cases, severe postpartum bleeding is possible, which is the most common cause of death during childbirth.
“2%, that’s two out of 100 women. Then it needs to be explained, understood, and the patient also has to assume that if I need a blood transfusion or some other intervention, it won’t be possible to do it outside the hospital. – from the point of view of patient safety, of course, the safest way to give birth is where there is a wide range of modern help, “points out Anna Miskova, the head of the Maternity Center of the Riga Maternity Hospital.
Why do pregnant women choose to give birth outside the hospital? There is no single answer to this. “Stork’s Nest” says the walls of houses and the people around them are important to many pregnant women. This is also emphasized by family psychologist Vita Kalniņa, who works with pregnant women on a daily basis.
According to her, inpatients tend to pay too little attention to emotional health. Therefore, the psychologist allows mothers to seek emotional security in home births.
“Sometimes, if too much emphasis is placed on physical, emotional security may remain somewhere. Emotional security is also provided by the environment. And where we feel even safer than at home. Of course, anywhere else, including the stationary environment, especially, if the mother has some negative experiences before – it can basically create a feeling of insecurity, “explains Kalniņa.
However, experts do not allow to say where to give birth is more correct. It is difficult to say what is higher – the mother’s individual choice or, possibly, higher safety standards.
“I think it is important to understand that it is not right to contrast inpatient and outpatient births, as long as they take place in accordance with guidelines, medical understanding, physiological processes and human wishes,” says Ceplis.
Miskova, on the other hand, points out: “I agree that a person can make an autonomous decision, but it is very important that when a person makes this decision, he understands both the negative and the positive sides.”
It should be reminded that a future mother died in Jelgava last year as well. However, these births are not among the planned outpatients, because they took place without the participation of medical staff. The woman was involved in a sect that chose to rely on a helper.