A CURRENT OVERVIEW OF PLANNED HOME DELIVERIES IN THE WORLD; RISKS AND BENEFITS

A CURRENT OVERVIEW OF PLANNED HOME DELIVERIES IN THE WORLD; RISKS AND BENEFITS SUMMARY: In developed countries, the planned home delivery rate varies between 0.1% and 20%. In the last 20 years, especially in developed countries, the number of women planning birth at home increased noteworthy. For planned home births, most maternal outcomes were reported positive, and are compatible with each other according to the results in the previous literature. However, the results for the neonatal outcomes are more variable. Planned home births in low-risk women results with lower levels of oxytocin induction, cesarean/operative delivery, postpartum hemorrhage, perineal laceration, need for pharmacologic analgesic and episiotomy intervention and maternal morbidity, according to the previous reports. In addition to the studies indicating that there are no differences for low-risk women between hospital and home births; in terms of intrapartum fetal deaths, neonatal deaths, low Apgar scores, and admission to the neonatal intensive care unit rates, other studies report increased negative neonatal outcomes. Planned home births are reported to be safer for multiparous pregnancies, especially when they are compared with nulliparous women who have small but significantly increased neonatal risks. However, home delivery is not recommended for women with breech presentation, multiple pregnancies and previous cesarean section. It has been reported that women are better able to control their environment in home births, determine their own conditions, avoid undesired interventions, and increase their satisfaction because they can play an active role in decision-making at birth. Another advantage for home deliveries is cost effectiveness. On the subject of birth at home, there is an obstacle on research designs because it is not feasible to conduct randomized controlled studies. Planned home births were effected by maternal care during pregnancy, the level of education of obstetricians and midwives who support during pregnancy and delivery, and the distance to hospital and transfer conditions for the mothers. The practices and guidelines based on the internationally accepted standards are important for the home birth safety. It was found that in the presence of trained midwives / obstetrician guided guidance and integrated transfer systems, the risks of home birth for low-risk women were very few or similar to hospital deliveries, especially in the terms of newborn results. This review will evaluate the relationship between planned home births and maternal and neonatal