Home or Hospital: Where Is the Safest Place for Delivery Right Now?

There is no feeling that can compare to holding your new baby for the first time. You’ve envisioned this moment for months, and now that the time has finally come, the world around us is bringing uncertainty. So how does coronavirus impact your plans when it comes to labor and delivery? Do stay-at-home or safer-at-home orders mean a home delivery is a better option than going to the hospital?

With new information coming available daily, we asked AdventHealth Medical Group’s Medical Director of obstetrics and gynecology, D. Ashley Hill, MD, to weigh in.

Pregnancy and Coronavirus

“I would consider pregnant women to be part of the high-risk category, and therefore they should take extra precautions,” Dr. Hill says. As more research has become available, the Centers for Disease Control and Prevention (CDC) includes pregnant women in its list of those who need extra precautions during the spread of coronavirus.

As part of the higher risk group, the CDC recommends the following to help pregnant women protect themselves:

• Avoid close contact with others (at least six feet)
• Avoid cruise travel and non-essential air travel
• Clean and disinfect frequently touched surfaces
• Stay home if possible
• Wash your hands often

The CDC has also shared that it is always important for pregnant people to protect themselves from illness, and at this time the “transmission of coronavirus during pregnancy.is unlikely.”

However, once the child is born, there are some added risks associated with COVID-19 for babies. After birth, the CDC says, “a newborn is susceptible to person-to-person spread,” just like the rest of us. Research has shown a very small number of babies have tested positive for coronavirus after birth, but it is not known how they contracted the virus, whether it be before or after birth.

Labor and Delivery Options

So, we’ve been asked to stay at home because right now that’s the best way to limit the spread of germs. Of course, this can be challenging for many of us to adhere to for different reasons, but for those who are about to give birth, there is an exception to following that rule. The stay-at-home order does not necessarily mean that home is the best place to be during labor and delivery.

A hospital is the safest setting for a birth, Dr. Hill explains, pandemic or not. “I often hear moms say they want to do everything possible they can to protect their baby,” Dr. Hill says, “and if that’s the case, the evidence seems to point away from home deliveries.”

It is perhaps an unsettling time to bring a new baby into the world, with changing visitor/guest policies and still much uncertainty about the pandemic, but rest assured, AdventHealth for Women is prepared to welcome your little one safely with the help of our Birth Experience Team.

Why Not Have a Home Birth?

Complications can arise during delivery unexpectedly. If that happens, a home birth could be more dangerous, as babies born at home in the U.S. have higher rates of infant mortality and other complications. “We try to create as home-like an environment as we can and work with patients to customize their birth process to give them the experience they want, while still making it safe for mom and baby,” Dr. Hill says. Women are still able to customize their birth experience, meaning how you want to labor, even amidst coronavirus.

According to the American College of Obstetricians and Gynecologists, there is double the risk of the baby dying during a home delivery and three times the risk of the baby having seizures after delivery. However, the overall risk of either of these complications is low, about 1-2/1,000 deliveries.

While the vast majority of babies born at home do not suffer for it, the risks are higher for the baby when born at home.

“I’m very comfortable telling low-risk patients on their second or third baby that home birth leads to less interventions for the mother, but I’m also ethically obligated to say it’s more dangerous for the baby,” Dr. Hill says.

A hospital can provide services and technology generally not available at home, including equipment that:

• Helps the baby breathe
• Measures the baby’s oxygen and, if necessary, provides extra to them
• Removes extra fluid from their lungs
• Resuscitates them

There are some conditions under which a home birth is considered to be too dangerous to attempt, including when there is:

• A baby who is not positioned to come down the birth canal headfirst
• A mother who has had a previous C-section
• A problem with the placenta that could increase the risk of bleeding
• A multiple birth
• Growth restriction of the baby

Is it Safe to Go to the Hospital?

It's important to stay up to date with your medical care, and our facilities are employing new safety measures to protect you and our caregivers including when you visit us. They include universal mask use, temperature testing, social distancing, employee COVID-19 testing, visitor restrictions and keeping our COVID-19 symptomatic patients separated from other patients. Nothing is more important to us than you.

Staying Safe at the Hospital

Of course, feeling protective as a soon-to-be parent is very understandable. You want to protect your child from coronavirus and other germs and may feel ready to do that by any means necessary. But please know that a home birth may not provide that protection and could lead to more concerns.

At AdventHealth for Women, our Birth Experience Team works with mothers to create their birth wishes for delivery and work hard to make the experience as close as possible to that vision, given the current limitations brought by coronavirus.

You’re welcome to take a virtual tour of our locations and have a phone consultation with a Birth Experience Coordinator. There are also online parent education classes and educational resources available via the Baby Place Academy.