Home Births in India: An Overview

A home birth is carried out in a non-clinical setting, attended or unattended by a medical professional, typically using traditional and natural childbirth methods.

Every mother obviously wants a normal delivery, but some women are not privileged enough to expect one. Home birthing still seems to be the prevalent mode of giving birth in rural India. Because of the glaring economic disparities, millions of newborns are stranded without the medical care that seems to be taken for granted in our society. Women who are unable to afford medical care or are unable to access it, a home birth becomes the default manner of childbirth.

In these rural spaces, the pregnant women depend on the elder women in the community, or the ones who have successfully completed a pregnancy before and create a birth community around them, where they systematically build systems of care, and deliver successfully. In an attempt to shift home births to medical institutions, Prime Minister Narendra Modi announced a scheme to provide financial aid, Rs. 6000 across 650 districts, to pregnant women who opt for institutional delivery.

What do statistics say?

India accounts for 17% of all maternal deaths globally. Our maternal mortality rate is 167 per 100,000 live births, and the infant mortality rate is approximately at 43 per 1,000 live births. Among the causes of these numbers, insufficient medical care during pregnancy and childbirth, and malnourishment takes precedence. There are approximately 444 million children in India. The National Family Health Survey indicates that only 54% of the infants are fully immunised and that more than half the births take place at home.

According to a survey on home birth attendants in low income countries, published in BioMed Centrail, a total of 1226 home birth attendants were surveyed. 80% had one month or less of formal training, less than half were literate, most of them did not possess basic equipment. Only Indian auxiliary nurse midwives, who perform mainly clinic births, were trained.

In India, statistically, less than two women in ten receive the medical attention that is prescribed, by a qualified medical professional in 2010. While approximately 16.2% women in rural India initiate home births, 10.8% women in urban India also give birth at home. One in four births are attended by “untrained officers”, fluctuating from 53.3% in Jharkhand to 5.3% in Delhi and 0.2% in Kerala.

Why are more and more women choosing home births?

National statistics suggest that due to medical advancement, state initiatives, and awareness about cesarean births, 90% of child-births are now conducted in medical institutions. And yet, there’s an emerging class of women who are willingly giving up hospitals and choosing midwives, or other qualified birthing professions, to deliver their babies at home.

When asked why, the common factor was the elimination of strangers delivering their baby and post-delivery care. Some women believe that in a hospital, the staff treats the pregnant woman like a patient, and her baby as a disease that needs to be cured. Especially in the case of a caesarean birth. According to the World Health Organisation, the recommended rate of C-section deliveries is 10-15%. The National Family Health Survey, 2015-16, indicated the rate at 87%, in 15 states and union territories. The yearly rate of cesarean deliveries has been 16.7%, one of the highest in the world. The scare of being put under anaesthesia, the statistics of survival and the complication, ongoing as well as post-op, warps the natural birthing process, and turns it into an ordeal that must be suffered. There are also reports of mental and physical abuse during deliveries, denial of admission, and untimely delays in medical care, specially in government hospitals. These women consult a hospital/health care provider, go to the hospital for regular check-ups, medical sonography, but chose a midwife to take over in the last trimester and deliver at home.

Making home births a better experience

To make the home birthing process smooth, Lamaze classes are suggested for expectant parents. Experts suggest that expectant parents should always question and demand a better birthing experience, and if that experience can be given at home, then that’s that.

Data suggests for newborns in India, home births supervised by health professionals are far safer than medical institution deliveries. Statistically, 255 die out of 10,000 hospital births, compared with 198 deaths in every 10,000 home deliveries facilitated by professionals. Although, for rural India or the urban poor, the prospect of home birth needs urgent improvements in the quality and hospitality, awareness of post-natal care, sanitation, and local help services.