Registering a home birth

The identity of the person who gave birth is verified by the person who handled the delivery (usually a midwife) and this information is recorded in the patient records of the newborn child.

The registered professional who handled the planned home birth brings the newborn’s umbilical blood sample to the maternity hospital. At the same time, the personal data of the person who gave birth are indicated, as well as the person who verified the data and the source of verification. A temporary official personal identity code is generated for the child at the hospital, and this identity code is used for creating a service contact: entries only.

The service contact enables the orders for TSH samples, booking of POVA appointments, and recording the agreed information as entries. Instructions for creating a personal identity code and service contact can be found in Apotti’s support portal, and the instructions are also currently in use in the maternity units.

Information on the new mother that may be relevant to the subsequent treatment of the newborn is recorded in the system entry. The content takes into account the information required by the National Supervisory Authority for Welfare and Health, Valvira, on the reason for taking a blood sample, the person drawing the sample, and the time of sampling.

In addition, the entry needs to record who has provided the information on which the data is based. A printout can be taken from the data entry, which the home-birth midwife will deliver to the family. Once the newborn’s temporary official personal identity code has become final, the current instructions will be followed for combining the data.

The information to be recorded as an entry are included below (an entry template will be created to guide the recording of data).

The following data is based on information received from the newborn’s mother. The information has been received and the mother’s identity verified by the midwife who handled the birth. The mother’s contact information is recorded in the newborn’s contact information.

• Midwife’s name
• Healthcare professional’s registration number
• Other person who handled the childbirth
• Mother’s live births; number of this newborn
• Weeks of pregnancy
• Mother’s ABO Rh
• Mother’s illnesses
• Abnormalities during pregnancy
• Mother’s medication during pregnancy
• Child’s date of birth
• Child’s gender
• Apgar score
• Vitamin K (preparation, dose, method of administration)
• General description of condition at time of birth and adaptation phase
• Rupture of fetal membranes
• Color of amniotic fluid
• First stage of labor
• Second stage of labor

The person who assisted in the childbirth can also submit the notification of birth using a separate notification form.

The midwife who handled the home birth takes a sample from the child for statutory screening and brings it to the hospital for examination. The test result will be reviewed at the appointment booked for the newborn.

The date and time of sampling (child’s date of birth) and plans for follow-up care are recorded: POVA appointment agreed: (date, time, hospital and ward, address, phone number).

The newborn’s parents or the healthcare professional who assisted in the childbirth will contact the maternity hospital’s clinic nurses at POVA or the neonatal outpatient clinic (Jorvi L2AVO) either on the day of delivery or the following working day and make an appointment to have the newborn examined. The aim is to arrange the examination appointment on a weekday when the child is 2–5 days old.

Contact information:

Women’s Hospital, Ward 52, shift supervisor, tel. 040 5959 354

Jorvi Hospital, Neonatal Appointments (JOL2AVO), tel. 09 4716 5384

Jorvi Hospital, Maternity Ward, appointments for postpartum women (N6B), tel. 09 4718 2174

During the appointment, the following is performed:

• The child is examined by a pediatrician.
• The child’s weight is measured, and if there is no previous data, also the height and head circumference are measured.
• A saturation screen is done, if it has not been done after the birth.
• The bilirubin level is assessed using a skin indicator and, if necessary, by taking a blood sample.
• A hearing test is conducted (OAE).
• A metabolism screening is programmed (VasSeu1).
• If an umbilical TSH sample has not been taken, thyroid values (TSH and T4V) are programmed to be taken when the child is at least 72 hours old.
• The parents are asked whether the child has been administered the dose of vitamin K.
• If necessary, BCG vaccination is programmed.

In addition to the above data, the pediatrician records the information about the pregnancy, childbirth (date and time of birth), placenta, the Apgar scores, saturation screen and the child’s condition after birth, as well as information about the TSH sample (who took the sample and who delivered it to HUSLAB) in the information system (Apotti). In addition, a record is made of the name and professional title of the healthcare professional who handled the birth, as well as the person who provided the above information.