Health Ministry agrees to ease rules on home births
Officials believe it is safest to deliver in hospital, but decide on compromise amid demand for home births.
Mother and baby Photo: Thinkstock/Imagebank
Although the Health Ministry opposes home births, it has just issued detailed
guidelines that make it easier to deliver in one’s own bed while at the same
time protecting the rights and health of the baby as much as
“It’s a compromise,” Prof. Arnon Afek, director of the
ministry’s medical branch told The Jerusalem Post on Thursday. “We prefer that
women give birth at hospitals, where all the equipment and qualified personnel
are, instead of having a trained midwife deliver the baby alone, but there is a
demand for it among some women, and in ideal circumstances it is considered
safe. There are home births in Western countries around the world,” he
Until now, the regulations were much more restrictive.
did not know of any lawsuits pressing for more liberal rules on home births, he
said, but there have been requests from women and queries by lawyers.
worked on the regulations for months. The team included Prof. Prof. Vaclav
Insler, chairman of the National Council for Gynecology, Neonatology and
Genetics, ministry physicians and legal experts.”
He called the reform “a
“We believe that it is safest to deliver in a hospital, but
we can’t deny that some women prefer to have their babies in a non-hospital
setting at home.
We tried to provide the best solution and bridge the two
positions,” continued Afek.
According to ministry estimates, in an
average year, between 400 and 600 women give birth at home by choice.
the National Insurance Institute (NII) gives special grants to women only if
they give birth in a hospital or if they immediately afterwards go to the
hospital, as in the case of women who unintentionally deliver elsewhere because
they did not reach the the delivery room in time. Women who intentionally have
their babies at home may not receive them.
The NII allocation is NIS
1,695 for new mothers, NIS 763 for a second baby and NIS 509 for every
Afek could not predict how many more women would
choose to deliver at home due to the new regulations, which had not been changed
since 1976 and were initially set during the British Mandate in
Only a professional – a registered midwife or obstetrician who has
undergone special training in neonatal resuscitation – may deliver babies, and
only at the home of the woman giving birth. Afek explained the latter limitation
by stating that the ministry did not want midwives to delivery babies at their
own homes or other residences that would be turned into mini-home- hospitals. The
woman’s home must not be more than 30 minutes away from the hospital, and the
home delivery room must be big enough, clean and have electricity, water and
Of course, in an emergency in which a woman suddenly
goes into labor, a paramedic or anyone else who is present is allowed to deliver
As it is not easy for midwives to obtain insurance to cover every
eventuality in home births, the guidelines stated that if the midwife lacks
insurance for this, she must inform the woman who commissions her that she has
The new regulations state that home births must be prepared
in advanced and are approved only if strict criteria are met.
includes having the fetus in the head-down, rather than the breech, position and
in the 37th to 42nd week of gestation; the estimated birth weight at 2.5 to 4
kilograms; a declaration of good health by the woman, who must be at least 18
years old; written documentation of her medical history; documentation of a
previous ultrasound of fetal systems; and that the mother does not have
In addition, the home must be equipped with a
delivery kit; sterile, disposable gloves and a suture kit; a portable suction
equipment; oxygen balloons; a sphygmomanometer for measuring blood pressure;
saline solution and infusion equipment; catheters; a baby scale; and a
thermometer, as well as sterile pads, test tubes and other
A home delivery may not be performed, the regulations
state, if the mother has an active infectious disease or a chronic disease that
would affect the fetus or delivery, if the woman previously had a delivery with
complications, if she took narcotics, or if she previously had a stillbirth that
could affect the present pregnancy.
Women with a multiple pregnancy or
those with a fever over 37.5 degrees Celsius may not be delivered at
When a baby is delivered at home, the midwife must give counselling
on basic baby care, and the infant must be taken to the hospital two to seven
days afterwards to undergo blood tests to determine whether it has certain
“One of the most important things is the requirement of the
midwife to explain every aspect of the potential risks of and conditions for
home births,” Afek said.
Asked whether midwives are permitted to deliver
babies outdoors – as in the Red Sea with dolphins swimming alongside, as some
women have done – Afek declared that this was forbidden and discouraged, but
that women could not be forbidden by law from doing it themselves.