Stating that home birth is a legal right in Türkiye, Faculty of Health Sciences Midwifery Department Asst. Prof. Tuğba Yılmaz Esencan said that "No law prohibits a woman from giving birth to her baby in a home environment. In practice, however, the situation is somewhat different. The Ministry of Health recommends that births take place in a hospital setting, and state-guaranteed maternity services are almost exclusively limited to hospitals."
Asst. Prof. Tuğba Yılmaz Esencan stated that "In recent studies, it has been reported that prenatal care is insufficient, the need for neonatal intensive care and maternal mortality rates are higher in unplanned home births. Home birth is not recommended, especially in women with a history of breech presentation, multiple pregnancies or previous cesarean sections."
Üsküdar University Faculty of Health Sciences Vice Dean, Midwifery Department Asst. Prof. Tuğba Yılmaz Esencan stated that the "Midwives Week", which is celebrated between April 21-28, offers an important opportunity to draw attention to the importance of the midwifery profession and to raise awareness in this field, and discussed the issue of home birth and returning to the nature of childbirth.
Is home birth legal in Türkiye?
Stating that the issue of home birth, which is increasingly discussed on the agenda of this year, Asst. Prof. Tuğba Yılmaz Esencan said that "Home birth is a legal right in Türkiye. No law prohibits a woman from giving birth to her baby in a home setting. In practice, however, the situation is somewhat different. The Ministry of Health recommends that births take place in a hospital setting, and state-guaranteed maternity services are almost exclusively limited to hospitals. Therefore, a woman who wants to give birth at home should find a trained midwife and obstetrician with her own means. Although this is a legal right, it makes it difficult for the practice to become widespread."
Pros and cons of home birth
Explaining that planned home births can be safe when they are well prepared for birth, low-risk pregnancies, provided with appropriate home birth conditions in the presence of midwives and when the conditions do not pose a risk for home birth, Asst. Prof. Tuğba Yılmaz Esencan continued her remarks as follows:
"Among the main reasons why women prefer home birth; to be able to control the birth environment, to avoid unwanted medical interventions, to give birth in a calmer environment and to take an active role in childbirth. In addition, in planned home births; Interventions such as cesarean section, birth induction, episiotomy are less frequent. On the other hand, unplanned or risky home births can carry serious health risks for both mother and baby. In recent studies, it has been reported that prenatal care is insufficient, the need for neonatal intensive care and maternal mortality rates are higher in unplanned home births. Home birth is not recommended, especially in women with a history of breech presentation, multiple pregnancies or previous cesarean sections."
Is home birth safe?
Noting that in recent years, non-invasive and female-centered approaches that respect the natural process of childbirth have started to attract more and more attention. Asst. Prof. Tuğba Yılmaz Esencan said, "In this context, the question 'Is home birth safe?' is frequently asked by both expectant mothers and health professionals. Answer is yes, it can be safe, but with some conditions. A comprehensive systematic review and meta-analysis published in The Lancet in 2019, including data on nearly 500,000 births, revealed that there was no significant difference in neonatal or perinatal mortality rates between planned home birth and hospital birth. "This finding strongly supports that home birth is safe as long as the birth takes place within well-integrated health systems, accompanied by trained midwives."
What happens in an emergency?
Stating that trained midwives work with the equipment and medicines to perform the necessary emergency interventions during childbirth, Asst. Prof. Tuğba Yılmaz Esencan said that "An organization is provided in such a way that fast hospital transfer can be made when necessary. As a matter of fact, a study conducted in the Netherlands showed that even in a serious situation such as postpartum hemorrhage, all mothers recover completely with the effective intervention of midwives. According to the Cochrane Review published in 2023, it was stated that planned hospital births do not always produce better outcomes in uncomplicated pregnancies, but on the contrary, they can be associated with more interventions, cesarean sections and neonatal problems."
Benefits of home birth
Pointing out that home birth provides not only physical but also psychological and social benefits, Asst. Prof. Tuğba Yılmaz Esencan said that "In a study conducted in England and Ireland, it was observed that women who gave birth at home had higher breastfeeding rates. In addition, fathers who witnessed the birth at home described the experience as 'magical' and 'transformative'. Home birth can be a safe alternative for low-risk pregnancies when planned within appropriate health systems and accompanied by trained health professionals. Accessing accurate information on this subject and enabling women to make informed choices is of great importance for mother-baby health. Home birth is also legally possible in Türkiye; In other words, no woman faces criminal or legal sanctions for her decision to give birth at home. However, the approach of the Ministry of Health encourages births to be carried out in health institutions such as hospitals, accompanied by expert health personnel."
The midwifery profession is a "living cultural heritage"...
Asst. Prof. Tuğba Yılmaz Esencan stated that the midwifery profession is not only at the time of birth; Stating that it has a very important role in processes such as pre-pregnancy education, pregnancy follow-up, birth management and postpartum care, she reminded that UNESCO defines the midwifery profession as a "living cultural heritage".
Noting that although the midwifery department has been among the most preferred departments among university candidates in Türkiye in recent years, many midwives still work in the field under conditions that are not visible enough. Asst Prof. Tuğba Yılmaz Esencan said that midwives are not only those who give birth; She said that there are professionals who support women's, infants' and community health holistically.
International approaches...
Emphasizing that the approach to childbirth and midwifery services differs greatly in different countries of the world, Asst. Prof. Tuğba Yılmaz Esencan said that "These differences are mostly shaped by the health systems of the countries, the meaning attributed to childbirth, the role of women in childbirth and the trust in health professionals. Especially in developed countries, home birth has started to gain importance again as an option."
The concept of "controlled, sterile, medical birth" is now being questioned
Noting that the understanding of "controlled, sterile, medical birth", which has been going on for centuries, is now being questioned, Asst. Prof. Tuğba Yılmaz Esencan said that "As the interest in subjects such as natural life, healthy nutrition and organic life increases, the demand for a 'natural' approach to birth increases. The fact that women want to have more say in childbirth makes home birth come to the fore again. However, for this process to be carried out safely, there is a need for legal regulations, strengthening the midwifery system, insuring midwives against malpractice and increasing public awareness. An investment in a midwife is an investment in women and society. Midwives do not just deliver babies and they bear witness to the birth power of women and represents the human face of the health system."
Üsküdar News Agency (ÜNA)