Home birth is a safe choice for mother and child if the decision is made carefully and with an adequate assessment of the risks, and if the birth is assisted by a competent midwife with a home birthing license. Also, when giving birth at home, it must be possible to transfer the mother and child to the hospital.
If you are considering a home birth, read more about what you need to know when planning a home birth, which midwives are allowed to provide home birth assistance services, and how the birth of a child is registered in this case.
What is home birth?
Planned home birth is a birth planned at the request of the pregnant woman during the planned monitoring of the pregnancy, agreed upon in advance during the visits, and received by a midwife in home conditions outside of the hospital. Birth at home has been officially allowed in Estonia since August 1, 2014, and the entire process and more detailed information can be found in the home birth guide.
The regulation of home births is based on the definition of normal labour by the World Health Organisation: "Normal labour begins spontaneously, labour is low-risk both at the beginning and throughout the labour process. The child is spontaneously born in the head-first position between the 37th and 42nd week of pregnancy. After the birth, the mother and the newborn are in good condition." In the case of home birth, all the conditions specified in the definition must be met.
What to consider when planning a home birth?
When planning a home birth, both parents should first read the home birth guide to familiarise themselves with the current regulations, then tell the midwife or doctor monitoring the pregnancy about their desire to give birth at home. To start the process of planning a home birth, you must first fill out a declaration of intent.
After receiving your application, the midwife or doctor will fill out the childbirth risk assessment table together with you. Before submitting your request, you can find out in the guide about the situations which will prevent you from giving birth at home. You will not be allowed to plan a home birth if the home is located more than 30 km from the nearest hospital providing maternity care. You can find the risk assessment table here.
If the initial risk assessment has been done together with the midwife or gynecologist monitoring the pregnancy, we recommend contacting a suitable home birth midwife. In this way, you can plan the home birth together, carry out a repeated risk assessment and, in case of low pregnancy and childbirth risks, also sign a contract.
Home birth midwives
Home birth care can only be provided by a midwife licensed by the Health Board, who:
- has documented experience of receiving at least 150 births at an obstetric care provider during the last 5 years or the corresponding level of professional qualification;
- has completed the theoretical and practical training in neonatal resuscitation once a year, recognised by a professional association;
- has completed the theoretical and practical training in adult resuscitation once every two years, recognised by a professional association.
You can find information about midwives who have a license for home birth assistance here.
What documents are required for a home birth?
Home birth documents are the following: birth risk assessment form, contract, birth history and post-birth home visit protocol completed by the midwife in a form that enables electronic reproduction. You can find the document forms on the website of the Estonian Midwives Association . The service provider is responsible for completing and maintaining the documentation based on the regulation of the Minister of Social Affairs, "Conditions and procedure for documentation of healthcare service provision ".
After the birth of the child, the midwife providing the home birth service fills out the birth card and forwards it to the birth registry according to the current procedure. The midwife also sends the birth epicrisis to the health information system. The midwife registers every birth that took place at home, as well as births initially planned to take place at home but that ended with a transfer to the hospital for any reason (risks, family decision, etc.), in the registration form displayed on the website of the Estonian Midwives Association.
Issuance of a newborn’s identification code
Children born at home receive a personal identification code from the registry office or local government when naming the child, i.e. registering the birth. A home birth midwife issues a medical birth certificate for the child without a personal identification code. When parents go to register the birth, they have to bring their documents (passports or ID cards) and the medical birth certificate from the midwife. If one of the married parents goes to register the birth, they must submit the written consent of the other parent.
Home birth without the help of a licensed midwife
If a child is born at home without the presence of a licensed midwife (i.e. without obtaining a medical birth certificate), it is strongly recommended to call an ambulance immediately. The ambulance can assess the condition of both mother and child, provide help if necessary and safely transport both to the hospital. In this case, there will also be no problems with the registration of the child. If the baby is born at home and the family decides to immediately transport both the mother and the newborn to the nearest hospital, the placenta (if abrupted) should be taken to the hospital for evaluation. It must be taken into account that such activity is associated with very high risks for both the mother and the child, and is not recommended. If the healthcare worker has not seen the birth and provided obstetric care, there may also be problems with obtaining a personal identification code for the child, and it is necessary to go to court to confirm the child’s descent. In this case, birth registration is possible based on a court order establishing the child’s descent from the mother.