The rate of home births has increased during the past several years in the U.S.  Regardless of  the circumstances of the birth, including location, every newborn infant deserves health care that adheres to AAP standards.  The safest setting for a child’s birth is a hospital or birthing center, but recognizes that women and their families may desire a home birth for a variety of reasons.  Pediatricians should advise parents who are planning a home birth that AAP and ACOG recommend only midwives who are certified by the American Midwifery Certification Board.  There should be at least one person present at the delivery whose primary responsibility is the care of the newborn infant and who has the appropriate training, skills and equipment to perform a full resuscitiation of the infant.  All medical equipment, and the telephone, should be tested before the delivery, and the weather should be monitored.  A previous arrangement needs to be made with a medical facility to ensure a safe and timely transport int he event of an emergency.  AAP guidelines include warming, a detailed physical exam, monitoring of temperature, heart and respiratory rates, eye prophylaxis, vitamin K administration, hepatitis B immunization, feeding assessment, hyperbilirubinemia screening and other newborn screening tests.  If warranted, infants may also require monitoring for group B streptococcal disease and glucose screening.  Comprehensive documentation and follow-up with us at Associates in Pediatric and Adolescent Medicine within 48 hours after birth is recommended.  If you have any questions , please call our office during business hours.

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