TABLE 1

Planned Home Birth Considerations

Potential candidate for home birth
 • Absence of preexisting maternal disease
 • Absence of significant disease arising during the pregnancy
 • A gestation of 37 + 0/7 to 41 + 6/7 weeks
 • A singleton fetus estimated to be appropriate for gestational age
 • A cephalic presentation
 • Labor that is spontaneous or induced as an outpatient
Reported risks to the newborn associated with planned home birth in the United States
 • Increased fetal and/or neonatal mortality58
 • Increased incidence of neonatal seizures5,6,8
 • Higher incidence of an Apgar score <4 at 5 min5,6,8
Systems needed to support planned home birth
 • The availability of a physician or a midwife certified by the American Midwifery Certification Board (or its predecessor organizations) or whose education and licensure meet the International Confederation of Midwives Global Standards for Midwifery Education practicing within an integrated and regulated health system
 • Attendance by at least 2 care providers, one of whom is an appropriately trained individual (see text) whose primary responsibility is the care of the newborn infant
 • Availability of appropriate equipment for neonatal resuscitation12
 • Ready access to medical consultation
 • Access to safe and timely transport to a nearby hospital with a preexisting arrangement
  • As stated in Guidelines for Perinatal Care, fetal malpresentation, multiple gestation, and previous cesarean delivery are considered absolute contraindications to planned home birth.