Waar zou jij willen bevallen? Thuis of in het ziekenhuis? Bij geboortes met weinig risico is dat even veilig, blijkt uit een analyse van ongeveer 1 miljoen bevallingen. Al zijn de gynaecologen niet overtuigd.
Drie jaar geleden beviel Kelly Van Damme thuis van haar dochtertje Lotta. “Al was dat helemaal niet de bedoeling. Ja, ik wou zo natuurlijk mogelijk bevallen. En ik wou niet al te lang in het ziekenhuis blijven. Maar thuis bevallen? Dat was toch nét iets te alternatief voor mij.”
Het liep anders.
Toen de vroedvrouw bij haar thuis arriveerde, had Van Damme al persweeën. “Opeens was het duidelijk dat ik het ziekenhuis niet meer zou halen, dus heb ik meteen de klik gemaakt. ‘Oké’, dacht ik, ‘mijn lijf is hiervoor gemaakt, dus dat moet lukken’. Vervolgens ben ik in mijn zetel bevallen.”
Vertrouwde omgeving
Ze had het niet zo gepland, maar toch vond ze het een fijne ervaring. Dus toen ze zeven weken geleden beviel van haar zoontje Pelle, koos ze wél bewust voor een thuisbevalling. “Weliswaar niet in de zetel, want dat was achteraf beschouwd toch niet zo praktisch. Maar ik vond het leuk om in mijn vertrouwde omgeving te kunnen blijven, met vroedvrouwen die ik vertrouw. Bovendien kon ik het deze keer echt bewust meemaken. De vorige keer overviel het me.”
Thuisbevallingen niet populair
Thuisbevallingen zijn in Vlaanderen niet populair. Volgens het meest recente jaarrapport van het Studiecentrum Perinatale Epidemiologie (SPE) gaat het om amper 0,63 van de bevallingen, al is dat wellicht een kleine onderschatting.
Even veilig als in ziekenhuis
Nochtans, bij een laagrisico-bevalling is de woonkamer even veilig als het ziekenhuis, leert een meta-studie die gepubliceerd staat in EClinicalMedicine, gepubliceerd door The Lancet. Wetenschappers van de Canadese McMaster University bundelden 21 studies gepubliceerd sinds 1990 waarin de uitkomst van thuis- en ziekenhuisbevallingen vergeleken wordt in Zweden, Nieuw-Zeeland, Engeland, Nederland, Japan, Australië, Canada en de VS. In totaal gaat het om ongeveer 500.000 thuisbevallingen en evenveel ziekenhuisgeboortes. Hun conclusie: bij een laagrisico-bevalling is de mortaliteit even groot thuis als in het ziekenhuis.
Complicaties
Joke Muyldermans, voormalig voorzitter van de Vlaamse Beroepsorganisatie van Vroedvrouwen, is niet verbaasd. “De risico’s zijn vaak overroepen. Het idee leeft dat thuis bevallen gevaarlijk is, maar het gaat om iets natuurlijks.” Veel hangt volgens haar af van de manier van bevalling en de vrouw. “Je moet goed op voorhand screenen. Het kan enkel bij moeders die fysiek in orde zijn, die een voldragen zwangerschap hebben, geen hoge bloeddruk…” In Nederland hebben ze een hele lijst met voorwaarden. Voldoe je daar niet aan, mag je niet thuis bevallen. “Wij vragen al jaren dat er ook zoiets komt in België.”
Bij de Vlaamse Vereniging voor Obstetrie en Gynaecologie zijn ze minder overtuigd van de kwaliteit van thuisbevallingen. “Wij zijn er zelf voorstander van dat vrouwen minder lang in het ziekenhuis verblijven”, zegt voorzitter Guy Verhulst, “maar thuisbevallingen vinden we onveilig, net omdat je nooit op voorhand kunt zeggen dat het een ‘laagrisico-bevalling’ is. Er zijn altijd complicaties die je niet kunt voorspellen. Duikt er thuis een probleem op, dan ben je altijd te laat.”
‘Alle vertrouwen’
Verhulst wijst erop dat in Nederland, waar thuisbevallingen veel meer ingeburgerd zijn, de neonatale sterfte ook hoger is. Verhulst: “Zeker in een land waar je alle infrastructuur dichtbij hebt en waar alle mogelijke middelen voorhanden zijn, zie ik niet waarom je daar geen gebruik van zou maken.”
In de weken voor de geboorte van Pelle maakte Kelly Van Damme zich wel eens zorgen. “Maar op het moment zelf verdwenen die gedachten en had ik er alle vertrouwen in. Had ik toch naar een ziekenhuis gemoeten, dan had ik dat spijtig gevonden. Ook omdat ik vrees dat ik daar veel meer ‘medische keuzes’ zou hebben gemaakt waar ik eigenlijk niet achter sta. Eigenlijk is het logisch dat je het zotste wat je als vrouw ooit zal doen in je leven, doet op een plek waar je je veilig voelt.”
Wij zijn benieuwd; heb jij ervaring met een thuisbevalling? Zou jij het ooit overwegen? Waarom wel / waarom niet?
Bron: Sara Vandekerckhove voor De Morgen
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