Potential Implications of Emerging Non-Traditional Childbirth Practices on Neonatal Health

In recent decades, women are increasingly incorporating nontraditional perinatal practices in their labor and birth plans. Maternal-child health providers are becoming more aware of these practices, especially out-of-hospital births, water birth, vaginal seeding, and placental encapsulation. As an example, out-of-hospital births in the US have increased since 2004, and most are planned home births rather than unplanned. 1 MacDorman M.F. Declercq E. Trends and state variations in out-of-hospital births in the United States, 2004-2017. Birth. 2019; 46: 279-288 Crossref PubMed Scopus (116) Google Scholar Home births increased by 19% between 2019 and 2020, peaking in May 2020 during the height of the COVID-19 pandemic in the US, fueled in part by concerns for safety within a hospital environment. 2 Gregory E.C.W. Osterman M.J.K. Valenzuela C.P. Changes in home births by race and hispanic origin and state of residence of mother: United States, 2018-2019 and 2019-2020. Natl Vital Stat Rep. 2021; 70: 1-10 Google Scholar For women in other parts of the world, including low- and middle-income countries, home births represent cultural norms and align with beliefs about privacy, protection, autonomy, and rituals. 3 Adatara P. Strumpher J. Ricks E. Mwini-Nyaledzigbor P.P. Cultural beliefs and practices of women influencing home births in rural Northern Ghana. Int J Womens Health. 2019; 11: 353-361 Crossref PubMed Scopus (20) Google Scholar , 4 Rodriguez-Garrido P. Goberna-Tricas J. Birth cultures: a qualitative approach to home birthing in Chile. PLoS One. 2021; 16: e0249224 Crossref PubMed Scopus (5) Google Scholar , 5 Shrestha S.K. Banu B. Khanom K. Ali L. Thapa N. Stray-Pedersen B. et al. Changing trends on the place of delivery: why do Nepali women give birth at home?. Reprod Health. 2012; 9: 25 Crossref PubMed Scopus (55) Google Scholar As these nontraditional practices enter mainstream obstetric and pediatric clinical care, concern for potential adverse effects has emerged because many of these practices have been adopted without rigorous investigations or clinical trials. In fact, many are based on low-level evidence such as case reports and surveys, and their prevalence and potential benefits and/or complications are not entirely known.