On rare occasions — statistically more rarely than in hospital — a baby delivered at home dies, either before it is born or shortly afterwards. This is always a tragedy and there really is no consolation. However there are aspects of stillbirth or neonatal death at home from which bereaved families draw some comfort. (If you feel that your baby would not have died if you had been in hospital then the following considerations will be of no help at all.)

If his or her death seems to be inevitable or unpreventable, you may prefer that your baby is born at home...

Opting for delivery by your community midwives is not necessarily straightforward. Local health trusts vary in their enthusiasm for providing a home birth service, so that near neighbours may get a completely different service. The midwives, from the most senior, the director of midwifery services, downwards may feel obliged to deter you, either as a result of their own beliefs or because they are so instructed by their health authority policy. It seems likely that there would be many more home births if women were given a real choice in the matter, but all too frequently they find it difficult to ask for one or find that, if they do, they are further put off by the attitude of the midwife they first speak to.

It may be that the policy in your area is one of discouraging home birth and tha...

DVT is a risk for any pregnant woman, because in pregnancy, there are physiologic changes that enhance the blood clotting mechanisms of the blood, preparing the body for the separation of the placenta and the minor tearing that accompanies most normal deliveries. These changes set the stage for one of the significant causes of maternal mortalityЎЄpulmonary embolism. (A thrombus or thrombosis is a blood clot forming within a vein, usually a vein of the legs or pelvis. An embolus is a thrombus that breaks free of its attachment to the blood vessel wall and travels in the bloodstream to a major organ, such as the brain, lungs, or heart, causing serious illness or even death...

It is not common for a woman under 50 to have cancer, but it is not rare, either, and the frequency of cancer is increasing. Breast cancer and cervical cancer and precancer are the most common types. In the United States, there are approximately 3,500 cancer-complicated pregnancies each year.

Most women who have had cancer have an acutely heightened sense of their own mortality and fear that they may not live to see their child grown. For a woman whose overall prognosis is good, the increased risk of early death is not tremendous. However, each cancer survivor should visit this issue and come to peace with it. If you wish to get pregnant, consider these questions...

Every mother is a working mother, but some also work outside their homes. If you are already established in your work, you may have the status and the accrued salary advances that come with experience; you may have seniority or the benefits of a unionized job; you may have accrued additional weeks of vacation and other advantages of long employment. Wherever you are in your work life, your employment situation and goals will have to be considered as you approach motherhood, whether for the first time or again.

Which Path to Take?
There are three basic questions you need to ask yourself before you bring your baby homeЎЄlong before. They are:

— Do I want to work full time after I have my baby?
— Do I want to be a stay-at-home mother?
— Do I want to work, but with reduced hours and perhaps ...

Remember that you do not have to consult a doctor at all about having your baby at home. In fact not consulting one might be a wise precaution; GPs’ reactions can be surprisingly fierce, even when such doctors are normally mild-mannered and considerate.

However, it is worth analysing the reasons for such reactions. In most cases it will not be a result of sheer bloody-mindedness, although it can seem like it. It can be due to apprehension and a genuine belief that you are proposing something that will endanger you and the baby and of course the doctors reputation, notwithstanding the current evidence.

Part or all of this apprehension will stem from the doctors previous experience of childbirth during his or her training, and may even go back further than that — to the type of person that h...

Fathers today are generally much more involved in the process of rearing children than they were a generation or two past. Most (but not all) fathers want to have a voice in all decisions regarding their children. Many want equal partnerships with the baby’s mother, and are willing to shoulder equal division of the chores. Many people, women and men, have preconceived ideas of how child care should be organized. It can be hard to realize that different styles and approaches may be equally workable and beneficial. Prospective parents need to talk about these issues without either being judgmental of the other’s ideas.

Single mothers will need to decide if possible how much a part of the child’s life the biological father will be...

There should be no automatic repeat Caesarean sections. In every case the need for this type of delivery should be assessed individually and in relation to the particular baby. The chances of having a vaginal birth following a Caesarean birth are good, although it will usually be described as a ‘trial’ of labor.

Such a birth is normally expected to take place in a consultant unit with facilities available for an emergency Caesarean section if necessary; this is because of the fear that your uterine scar may not stand up to the pressure of labor, and separate or rupture as a consequence. This happens only rarely — once in every 500 cases where the incision is of the lower-segment ‘bikini line’ kind. It is more common, 1-3 per cent, with classical up-and-down scar...

If you have been trying to conceive for six months without success, it may be appropriate to visit your doctor for help in finding out what’s preventing conception. The factors that decrease fertility fall into three main groups: First, problems associated with ovulation\ you must produce eggs (ova) in order to conceive. Second, what is referred to as male factor infertility or subfertility the man’s sperm count and the normalcy of the sperm produced and their ability to get from where they are produced (in the testes) to where they will fertilize the egg (in one of the woman’s Fallopian tubes). In an older man erectile dysfunction may also be a consideration...

Problems in labor are the big bogey with which women are often threatened when they ask to have their babies at home. Statistically less likely to occur than in hospital, they are none the less a possibility. Although women choosing a home birth may be justifiably more confident about things going smoothly than their medical advisors are, they must, in order to make an informed choice, contemplate the possibility of things going wrong.

You need to think about what might happen, what contingency plans should be made for such an event, what treatment could be given to either you or the baby while still at home and when it would be advisable or necessary to transfer to hospital. You should also be aware of ways of preventing a problem arising if possible, or of helping yourself once it has.

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