By Dewi Sriwahyuto

EVEN though it is legal in Singapore, doctors are advising against home-births for plus size Singaporean mums.

Women who are overweight (BMI of 25 and above) or obese (BMI of 30 or over), may experience
more complications during labour than those who are of a healthy weight (BMI of 18.5 to 24.9), doctors warned.

Obstetrician Lai Fon-Min, who carried out a home-birth for a Singaporean mum about three years ago, said: "I would support home-births only for mothers...who are at low risk of potential complications during delivery. Numerous studies have shown that mothers who are obese have a spectrum of increased risks to the mother and baby."

Ms Sharon Chan, editor for BabyCenter Singapore, an online resource for parents, said: "It's best that you discuss your birthing options with your obstetrician to find out if you're a good candidate for a homebirth.

In Singapore, you must also have a doula present at your home-birth and she will work closely with your doctor."

A doula is not a midwife. She is a trained labour coach who would assist mums during labour and delivery by providing them with emotional and non-medical support, such as explaining medical terms.

Dr Paul Tseng, 51, from TLC Gynaecology Practice at Thomson Medical Centre Singapore, said: "From the start, we don't encourage home-births in Singapore because hospitals here have all the facilities to ensure that a delivery goes well, so why open yourself to possible complications that you can't manage on your own at home?"

For example, one complication that obese women may encounter during delivery is water retention, said Dr Tseng.

This would lead to swollen tissues, which block the vagina.

When this happens, the mother has to push harder and this will result in a very bad tear in the vagina.

The wound has to be stitched up immediately to prevent excessive bleeding. If the midwife or the mother is not prepared for this situation, the mum may lose too much blood and the worst could happen.

Even for women with normal weight who are planning to have a home-birth, Dr Tseng stressed the need for ideal conditions - that is, there must be almost next to no risk of complications - before doctors would give them the green light.

dewisri@sph.com.sg

For more my paper stories click here.