Obstet Gynecol. 2016 Aug;128(2):e26-31. doi: 10.1097/AOG.0000000000001586.
In the United States, approximately 35,000 births (0.9%) per year occur in the home. Approximately one fourth of these births are unplanned or unattended. Although the American College of Obstetricians and Gynecologists believes that hospitals and accredited birth centers are the safest settings for birth, each woman has the right to make a medically informed decision about delivery. Importantly, women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes. These factors include the appropriate selection of candidates for home birth; the availability of a certified nurse-midwife, certified midwife or midwife whose education and licensure meet International Confederation of Midwives' Global Standards for Midwifery Education, or physician practicing obstetrics within an integrated and regulated health system; ready access to consultation; and access to safe and timely transport to nearby hospitals. The Committee on Obstetric Practice considers fetal malpresentation, multiple gestation, or prior cesarean delivery to be an absolute contraindication to planned home birth.
在美国，每年约有 35,000 例（0.9%）分娩在家庭中进行。其中约有四分之一的分娩是无计划或无人陪伴的。尽管美国妇产科医师学会认为医院和认证的生育中心是分娩最安全的环境，但每位女性都有权就分娩做出医学知情决策。重要的是，应告知妇女，有几个因素对降低围产期死亡率和实现有利的家庭分娩结果至关重要。这些因素包括适当选择适合家庭分娩的候选人；提供经过认证的护士助产士、认证助产士或助产士，其教育和许可符合国际助产士联合会的全球助产教育标准，或在综合和监管卫生系统中执业的产科医生；随时可以咨询；以及可以安全及时地转往附近的医院。产科实践委员会认为胎儿胎位不正、多胎妊娠或先前剖宫产是计划家庭分娩的绝对禁忌症。
