Illegal to have home birth in Thailand?

[Jane101]

Hi, I am wondering if it is actually illegal to have a planned home birth in Thailand? The websites I have read say that it is not encouraged by doctors and not covered by insurance. I wouldn't have a Thai doctor there and we are not covered by insurance and would be paying everything ourselves anyway. I understand you have to do all the legal requirements afterwards to get a Thai birth certificate including going to the District office etc.

[MissAndry]

Loads of villagers have babies, on their own, in the village, then once or twice a year they all troop down to the Amphur office and register the births. In some villages loads of kids end up with the same birth day on their birth certificates. It isn't a problem.

 

Planned home birth in western woman think?

I don't think there's much of that, here babies die, and mothers too.

I wouldn't chance it.

Edited September 4, 2016 by MissAndry

[KhunBENQ]

It's now 9 years that I got note of a home birth in the village (within the family).

I visited the newly erected shack where mother and child stayed after birth.

Hot water, herbal(?) steam, don't ask me what it was all about.

 

No idea whether it is anything illegal nowadays.

 

 

Edited September 4, 2016 by KhunBENQ

[Kabula]

Most moms in the villages outside of large cities can't afford hospitals and more and more are now single.

 

Moms and babies die even in  hospitals.

 

Many experts argue that a child birth at home is safer considering all the bacteria and viruses in hospitals, especially the older ones.  Some die in traffic accidents rushing to the hospital along with complications while in route.

 

Women have been having babies in their homes for ten thousand years, long before there were hospitals. 

[manfredtillmann]

if it just happens... who could punish you for that? just don't be too open about the planning part of it.

despite that, i would not recommend it unless it's your 5th delivery or so. just take in post #2.

[mankondang]

2 hours ago, Kabula said:

ns in thside of large cities  caamcoveredn't afford hospitals and more and more are now single.

 

Moms and babies die even in  hospitals.

 

Many experts argue that a child birth at home is safer considering all the bacteria and viruses in hospitals, especially the older ones.  Some die in traffic accidents rushing to the hospital along with complications while in route.

 

Women have been having babies in their homes for ten thousand years, long before there were hospitals. 

 

You say that most mums cannot afford hospitals. I am told it's free in Government hospitals. But i Understand that many treatments are not covered, but childbirth, many by Cesarian, was. You surprize with your information.

[FritsSikkink]

      "Women have been having babies in their homes for ten thousand years, long before there were hospitals. "

Yes and many of both have died in the process.

[autanic]

In the UK, my Wife wanted to have a birth in the local general hospital. When the contractions came, I did my bit and drove us to the hospital and checked her in. It was 7 hours before we even saw a Midwife. Despite my Wife being in considerable pain. Eventually we were told that the birth was a Breach Birth and she needed a C-Section. My Daughter was born, but my Wife got a very bad infection after surgery. She ended up on the Post Maternity Ward, where she was expected to breast feed, change nappies all while having a 17" cut in her abdomen. Which to add was infected. The nurses were not sympathetic at all.

 

Eventually she had another operation to remove the infected wound and had to undertake months of rehabilitation. I took on all the role of Mum and Dad to my Daughter and Nurse to my Wife.

 

We got through it.

 

My point is this, because of the lack of money, the hospital was not properly resourced to handle as many Mum's as it did and this put lives at risk.

 

If you want a home birth, you have one. Just have a car ready to rush to hospital, should the need arise.

 

Congratulations and the best of luck.

[BudRight]

On 9/4/2016 at 6:50 PM, Kabula said:

Most moms in the villages outside of large cities can't afford hospitals and more and more are now single.

 

Moms and babies die even in  hospitals.

 

Many experts argue that a child birth at home is safer considering all the bacteria and viruses in hospitals, especially the older ones.  Some die in traffic accidents rushing to the hospital along with complications while in route.

 

Women have been having babies in their homes for ten thousand years, long before there were hospitals. 

 

I find it hard to believe anyone is this stupid. Woman and child die at FOUR TIMES the rate in home births as they do in hospitals. Nobody talks about home-appendectomy or home-brain surgery. 

[Sheryl]

There is a directand very large  link between facility deliveries ad maternal and newborn deaths.

 

That said, it is possible to great;y reduce (though not 100% eliminate) the increased risk to associated with home birth by having a well trained birth attendant (doctor or fully qualified and experienced nurse or nurse-midwife) perform the delivery with a clear back-up plan including how to effect an immediate transfer to the hospital if necessary. (If you live in Bangkok or other area with a lot of traffic congestion - or if you live very far from the nearest tertiary level hospital - then that will be impossible to assure). And emergency resucitation equipment on hand.

 

However, I very much doubt you will be able to find a well qualified Thai nurse-midwife willing to do this, and any foreign ones would likely hesitate as it would indeed be illegal for them (practicing without a license). It is not illegal for the mother.

 

The main cause of maternal death is hemorrhage in the immediate post partum period. This cannot be predicted and it is possible to bleed to death in as little as 15-30 minutes.

 

The risk to the infant is even greater. That is also true if deliveries in a low level hospital without facilities to care for neonatal emergencies.

 

Personally I would not risk this. There are doctors/hospitals where it is possible to have a other-centered natural birth though few and far between and you have to seek them out. Definitely can be done in Bangkok and in CM.

 

 

[Kabula]

On September 5, 2016 at 11:45 AM, mankondang said:

 

You say that most mums cannot afford hospitals. I am told it's free in Government hospitals. But i Understand that many treatments are not covered, but childbirth, many by Cesarian, was. You surprize with your information.

• Many moms prefer private hospitals, but can't afford them and are very  concerned about the care in a government hospital, so many prefer having births at home.  This is what Thais have told me over the 9 years that I have lived here.  Most government hospitals worldwide are having problems keeping up with competent care due to staff reductions,  budget cuts, Government insurance programs being cancelled, negative press and more.  Emergency waiting times can be many hours which can be fatal!  

[Peterw42]

I dont know if illegal or not, but should be encouraged to attend a hospital/clinic etc.

I have seen first hand horrific results of a home birth in Australia. Me and my then wife met a couple at anti natal classes who were planning a home birth, against the advice of doctors/midwife etc, mainly because it was the couples first and risk of something going wrong is higher.

This couple went ahead with the home birth, They lived on a remote rural property a hour from a hospital, they had telephone service etc. However, they choose to pitch a tent, by a river, in a remote area on their property, away from the road and the telephone.

The birth went horribly wrong, cord around neck, breech etc. an hour later the husband got back to the house and called an ambulance, that ambulance got bogged trying to get to the remote area on the property and eventually a helicopter was brought in. 4 hours later the baby got to hospital. Unfortunately to late, the baby did not die but ended up brain dead, living on a drip etc.

This story actually gets worse. The couple had a midwife in attendance at the birth, but it turned out the midwife was a homeopathic, natrapath etc, not a licensed midwife, she was putting crystals on the babies head and burning incense. 

 

If you are having a baby, go to a big building full of doctors and nurses and equipment.

[IMA_FARANG]

For your info....when i lived in Vietnam my Vietnamese wife was a certified midwife and trained and certified by her father who was a liscensed doctor.

During the Vietnam war most Vietnamese women had little or no acess to hospital care to have there babies, most deliveries were done in the woman's home by a trained and certified midwife.

It was not unusual for my wife to be gone for the night as a neighbor was about to have her baby, which my wife would deliver that night.

More than once i was home when my wife was visted by an obviously very pregnant woman just starting to go into labor who wanted my wife to deliver her bsby thst night.

ironically, for medical reasons, my wife was unable to have children herself, but she delivered many children for her neighbors.

Just for futher info, my wife and I adopted a Vietnamese girl orphan as she could not carry a baby to term herself do to a heart probblem from her her youth.

I lost both my Vietnamese wife and our adopted daughter in April 1975 as they neve got out of Saigon.

So it goes.

 

 

 

Edited September 8, 2016 by IMA_FARANG

[Sheryl]

18 hours ago, Kabula said:

• Many moms prefer private hospitals, but can't afford them and are very  concerned about the care in a government hospital, so many prefer having births at home.  This is what Thais have told me over the 9 years that I have lived here.  Most government hospitals worldwide are having problems keeping up with competent care due to staff reductions,  budget cuts, Government insurance programs being cancelled, negative press and more.  Emergency waiting times can be many hours which can be fatal!  

 

Statistics for 2012 (year in which the last population-based survey of health indicators was done):

 

 

90.9% delivered in a government health facility.

 8.6% delivered in a private health facility

 0.2% delivered at home

0.3% delivered elsewhere (someone else's home, on the way, in the car/taxi etc).

http://www.unicef.org/thailand/57-05-011-MICS_EN.pdf

 

Altogether 99.5% for hospital delivery. Home births are virtually unknown here and usually the result of a rapid labor rather than choice.

 

Delivery is free in government hospitals for all Thai citizens, ditto antenatal care and no plans to stop this. While the financing of the universal care system is a headache, it is politically impossible to close the program down.

 

Crowded, yes. As to quality, varies with the level of facility. But should note that there is plenty of malpractice going on in private hospitals. Private = more comforts but not necessarily (or even usually) better medical quality.

 

 

 

 

 

 

[Kabula]

On ‎9‎/‎7‎/‎2016 at 7:10 AM, BudRight said:

 

I find it hard to believe anyone is this stupid. Woman and child die at FOUR TIMES the rate in home births as they do in hospitals. Nobody talks about home-appendectomy or home-brain surgery. 

Not true....

[Sheryl]

It is in fact true that both maternal and neonatal deaths are higher with a home birth than a hospital birth. However the magnitude of the difference will vary gretaly depending on the home birth circumstances (fully trained professional birth attendant vs. a lay person; ability to refer quickly to a hospital in case of complications, etc etc) and also on the hospital situation (in very poor countries hospitals sometimes lack round the clock doctors and proper equipment. In Thailand generally not a problem as long as the hospital in question is either a government hospital at provincial level or higher or it is a good, reputable private hospital. There are some small dodgy private hospitals around, and district level govt hospitals, while they are properly staffed and equipped for normal delivery, lack capacity to manger complications).

 

If comparing delivery at home by a lay person to delivery in a properly equipped/staffed hospital able to proved the full range of emergency obstetric/neonatal care would it be required, the magnitude of risk for the home birth is much, much more than 4 fold. More like 10 fold.

 

But if comparing a home birth conducted by a fully trained person, with emergency resucitation equipment on hand, following evidence-based standard protocol and with immediate access to transport to hospital then the magnitude of risk is much less - though there is still some increase.

 

Absolutely should not be done with other than a fully trained and experienced doctor or nurse/nurse-midwife in attendance, emergency equipment on hand and means of immediately getting to a hospital with surgical capacity and neo-natal ICU within 15 minutes.  If those conditions are met and the woman is willing to incur what in those conditions is still a small increase in risk, her choice.

 

The biggest problem is that people who elect to have home births are often planning to do so with an untrained person or "alternative" medicine provider and often do so with a "birth is normal, no problem" attitude and hence fail to make adequate emergency provisions / think through what they will do if things go wrong.

 

Birth is indeed natural...but in nature, many mothers die in childbirth and many infants die at or immediately after birth. Medical interventions have changed that dramatically for humans.

[Kabula]

17 hours ago, Sheryl said:

 

Statistics for 2012 (year in which the last population-based survey of health indicators was done):

 

 

90.9% delivered in a government health facility.

 8.6% delivered in a private health facility

 0.2% delivered at home

0.3% delivered elsewhere (someone else's home, on the way, in the car/taxi etc).

http://www.unicef.org/thailand/57-05-011-MICS_EN.pdf

 

Altogether 99.5% for hospital delivery. Home births are virtually unknown here and usually the result of a rapid labor rather than choice.

 

Delivery is free in government hospitals for all Thai citizens, ditto antenatal care and no plans to stop this. While the financing of the universal care system is a headache, it is politically impossible to close the program down.

 

Crowded, yes. As to quality, varies with the level of facility. But should note that there is plenty of malpractice going on in private hospitals. Private = more comforts but not necessarily (or even usually) better medical quality.

 

 

 

 

 

 

Virtually unknown here....that’s funny.  Just yesterday I was getting my haircut in Bangkok by a pregnant Thai women that was 7 months along.  Her living quarters were above her shop.  This was her 4th child and she said she delivered all in her home and would deliver this one as many Thais do in her home!

 

After my haircut I got a leg massage and asked the lady giving me a massage who was 23 years of age where her mom had her and her identical twin sister?  She said in her home.  They lived near Surin.  Her twin sister had her two children in the home as well.

 

The Thai women I lived with for 4 years was born in her home in Surin along with 7 brothers and sisters.  Her parents were born in the same home!

 

Mothers worldwide should be more concerned about their child dying in accidents, drug overdoses, gang fights, street crime, and more.

 

How many news articles have you ever seen where a child died while a mother was giving birth in her home?  Probably none.....

[wpcoe]

6 hours ago, Kabula said:

How many news articles have you ever seen where a child died while a mother was giving birth in her home?  Probably none.....

 

Maybe the links from this Google search are all fluff pieces?

 

https://www.google.com.sg/search?q=death+during+home+birth

[Sheryl]

There is a huge body of literature on this.

 

Decades of international experience has conclusively shown that the only way to get maternal mortality rates down is to increase the percentage of hospital based deliveries.

[BngkkB]

I know a farang mid wife that I believe goes to home births several times a year.

[Jane101]

Thanks for all the responses! Ironically manfretillmann this is my 5th pregnancy. The other 4 were pretty straight forward natural births in a western hospital. I am aware of the pros and cons of homebirths. We do live in a town in Thailand 5 -10 minutes drive from 2 adequate hospitals with the emergency gear necessary and yes we would have the car ready. We would also have experienced professionals at home with me. My issue about giving birth in a Thai hospital, private or public is more to do with the mounds of intervention that seems to be given  to women in during the birth process that I really don't want. For example I.V drips, constant fetal monitoring, c-sections (I am happy to have one if actually necessary of course), legs up in stirrups for birth, and baby whisked away for a period of time after the birth, etc. My experience of child birth has been a very natural, quiet and calm experience with just my husband and a midwife in the room, followed by loads of skin to skin with my newborn baby and being left to bond for the next couple of days peacefully in our hospital room, with midwives popping in now and then to say hello and let me know they were there if I needed anything. My question was really relating to whether or not it would be an issue with the Thai authorities to get a birth certificate for a Falang child after a homebirth with no visit to any hospital.

•  

[Sheryl]

It may prove more complicated  with no hospital to handle it for you, but the fact that the birth was at home does not preclude getting a birth certificate, and the only person(s) breaking the law would be the birth attendants if not licensed to practice medicine, nursing or midwifery in Thailand. 

 

I understand what you mean re births in Thailand. There are places and doctors where you can avoid all that (Samitivej in Bangkok has lovely birthing suites and can even do water births) but sounds like you are upcountry, where indeed not the case. Government hospitals will nto push c-section but will do all the other things you mention. Private ones will do all and push for c-s.

 

Do be very careful. As it is your 5th birth you are at above average risk for post-partum hemorrhage.