Planned home births in the Czech Republic, 2018

Česká verzia

Authors: J. Vintrová ¹; A. Pařízek ²
Authors place of work: Gynekologicko-porodnické oddělení Krajské nemocnice, Liberec, primář MUDr. P. Černý ¹; Gynekologicko-porodnická klinika 1. LF UK a VFN, Praha, přednosta prof. MUDr. A. Martan, DrSc. ²
Published in the journal: Ceska Gynekol 2018; 83(3): 204-211

Summary

Study aim:

A summary of the current situation regarding issues of planned home births in the Czech Republic.

Type of study:

Review and summarization.

Affiliations:

Department of Obstetrics and Gynecology of the Liberec regional hospital, and the Department of Obstetrics and Gynecology of the First Faculty of Medicine and General Teaching Hospital in Prague.

Methods:

We present a summarization of the available data on the controversial subject of planned home births in the Czech Republic. Planned home births in the Czech Republic are currently the subject of much professional, legal, and ethical discussion. This study also includes a review of the international literature, which describes the influence of planned home births on maternal and perinatal mortality and morbidity. There is as yet no professional organization or legal framework in the Czech Republic for regulating home births, and no precise and dependable data exits on the number, outcomes, or incidence of complications. However, there is an unambiguous consensus among all related specialist organizations in the Czech Medical Association of J. E. Purkyně, which does not support or recommend home births. Despite this, there is a small percentage of women that prefer to give birth at home. Through social networks and public discussion forums that deal with such issues these women find a community that supports and shares, but that also sometimes passes on half-truths and misinformation. Every initially physiological birth can without warning become complicated and require immediate medical intervention. Delays, and inadequate preparation and qualifications can fundamentally influence the further courses and outcomes, complicating the health and life of both mother and child.

Conclusion:

The aim of all specialists participating in any way with this issue should be the spread of indisputable facts based on evidence and warning of the demonstrable risks associated with planned home births.

Keywords:

planned home birth, risks, maternal and perinatal mortality and morbidity, statistics, rights, social networks, public discussion forums

Zdroje

1. ACOG Committee on Obstetric Practice. Planned home birth. Committee Opinion No. 697. American College of Obstetricians and Gynecologists. Obstet Gynecol, 2017, 129, p. e117–122.

2. Blix, E., Kumle, MH., Ingversen, K., et al. Transfers to hospital in planned home birth in four Nordic countries – a prospective cohort study. Acta Obstet Gynecol Scand, 2016, 95, p. 420–428.

3. Brouwers, HA., Bruinse, W., Dijs-Elsinga, J., et al. Netherlands Perinatal Registry. Perinatal care in the netherlands 2013. Utrecht: Netherlands Perinatal Registry, 2014.

4. Committee on Fetus and Newborn. Planned home birth, Pediatrics, 2013, 131, 1016; originally published online April 29, 2013; DOI: 10.1542/peds.2013–0575.

5. Chervenak, FA., McCullough, LB., Brent, RL., et al. Planned home birth: not a Dutch treat for export. Am J Obstet Gynecol, 2013, 208(1), p. 31–38. doi: 10.1016/j.ajog.2012.10.002.

6. Chervenak, FA., McCullough, LB., Grünebaum, A., et al. Planned home birth in the United States and professionalism: a critical assessment. J Clinic Ethics, 2013, 24, 3, p. 184–191.

7. Česká lékařská komora. Odborné stanovisko Vědecké rady ČLK k porodům v domácnosti [online]. 8. 3. 2012 [cit. dne 20. 12. 2017]. Dostupné z: http://www.lkcr.cz/aktuality-322.html?do%5BloadData%5D=1&itemKey=cz_99307.

8. de Jonge, A., van der Goes, BY., Ravelli, AC., et al. Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births. BJOG, 2009, 116(9), p. 1177–1184.

9. Evers, AC., Brouwers, HA., Hukkelhoven, CW., et al. Perinatal mortality and severe morbidity in low and high risk term pregnancies in the Netherlands: prospective cohort study. BMJ, 2010, 341:c5639. doi: 10.1136/bmj.c5639.

10. Grünebaum, A., et al. Apgar score of zero at five minutes and seizures or serious neonatal dysfunction in relation to birth setting. Am J Obstet Gynecol, 2013, 209(4), p. 323. e1–6.

11. Grünebaum, A., McCullough, LB., Sapra, KJ., et al. Early and total neonatal mortality in relation to birth setting in the United States, 2006–2009. Am J Obstet Gynecol, 2014, 211(4), p. 390. e1–e7.

12. Janssen, PA., Saxell, L., Page, LA., et al. Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. CMAJ, 2009, 181(6–7), p. 377–383.

13. Koubová, M. Porodník Pařízek: Ignorujme propagátory domácích porodů, protože ideologii nejde zlomit. Zdravotnický deník [online], 17. 2. 2017 [cit. Dne 20. 12. 2017]. Dostupné z: http://www.zdravotnickydenik.cz/2017/02/porodnik-parizek-ignorujme-propagatory-domacich-porodu-protoze-ideologii-nejde-zlomit/

14. Křepelka, P. Příspěvek k bezpečnosti domácích a ústavních porodů. Prakt Gyn, 2016, 20(2), s. 84–88.

15. Měchurová, A. Odborné stanovisko výboru ČGPS ČLS JEP a výboru sekce perinatální medicíny ČGPS ČLS JEP k porodům v domácnosti. Čes Gynek, 2013, 78, s. 29.

16. Pavlíková, M. Sbíraná data o porodu, zdraví a úmrtí novorozenců v ČR a EU. 30. 8. 2014 [cit. 21. 12. 2017]. Dostupné z: http://www.biostatisticka.cz/sbirana-data-o-porodu-zdravi-a-umrti-novorozencu-v-cr-a-v-eu/)

17. Pařízek, A. Plánovaný porod doma v České republice. Stanovisko České lékařské společnosti J. E. Purkyně a České asociace sester. 29. 8. 2013 [cit. dne 7.2. 2018]. Dostupné z: http://www.porodnice.cz/clanky/planovany-porod-doma-v-cr

18. Sedlák, M. Problematika domácích porodů z pohledu laické a odborné veřejnosti, Bakalářská práce, 30. 4. 2008.

19. Snowden, JM., Tilden, EL., Snyder, J., et al. Planned out-of-hospital birth and birth outcomes. N Engl J Med, 2015, 373(27), p. 2642–2653.

20. Válová, I. Štrasburský soud zamítl stížnost dvou Češek kvůli domácím porodům. Zdravotnický deník [online], 15. 11. 2016 [cit. dne 20. 12. 2017]. Dostupné z: http://www.zdravotnickydenik.cz/2016/11/strasbursky-soud-zamitl-stiznost-dvou-cesek-kvuli-domacim-porodum/

21. Wax, JR., Lucas, FL., Lamont, M., et al. Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis. Am J Obstet Gynecol, 2010, 203(3), p. 243.e1–e8.

22. Ústavní zákon č. 1/1993 Sb., Ústava České republiky, ve znění pozdějších změn a doplnění

23. Ústavní zákon č. 2/1993 Sb., Listina základních práv a svobod, ve znění pozdějších změn a doplnění