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* Abbreviations: AAP — : American Academy of PediatricsWe strongly disagree with Chervenak et al1 that the American Academy of Pediatrics (AAP) policy statement on “Planned Home Birth”2 diverges from its own primary principle, to promote the best interests of the child. First, the statement does not promote home birth. We begin, as the authors note, by agreeing with the statement of the Committee on Obstetric Practice of the American College of Obstetricians and Gynecologists that “hospitals and birthing centers are the safest setting for birth.” In addition, we state that the pediatrician should counsel expectant parents regarding the apparent risks of home birth in the United States. Subsequently, after the infant is born, we specifically promote the best interests of the child who is born at home by setting standards for care that adhere to those delineated in AAP publications.3The arguments made by Chervenak et al regarding the “best interests of the child” have several notable flaws. First, before delivery, the fetus is not an independent being (child), but a fetus, and the authors inexplicably ignore both the ethical principle of autonomy for the expectant mother and the difficult balance of maternal and fetal benefits and harms. Previous commentary by these authors advocates overriding both maternal and fetal rights, arguing instead for the “professional responsibility model of obstetric ethics, which emphasizes the importance of medical science and compassionate clinical care of both the pregnant and fetal patient. … Address correspondence to Kristi L. Watterberg, MD, Department of Pediatrics, MSC 10 5590, University of New Mexico, Albuquerque, NM 87131-0001. E-mail: kwatterberg{at}salud.unm.edu

Policy Statement on Planned Home Birth: Upholding the Best Interests of Children and Families