Malappuram has recorded the highest number of home births in Kerala, with 1,244 out of 2,931 deliveries taking place at home between 2019 and September 2024. Some individuals who opt for home births assert that such deliveries are not illegal and justify their decision to bypass the formal medical system.
Published Apr 09, 2025 | 9:00 AM ⚊ Updated Apr 12, 2025 | 11:38 AM
The debate took a darker turn following the recent death of a 34-year-old woman during a home birth in the same district.
Synopsis: A growing movement of unassisted home births in Kerala, particularly in Malappuram, has sparked legal, medical, and ethical concerns following a recent maternal death. While proponents defend the practice as a matter of bodily autonomy and natural healing, health officials warn of rising underground birthing networks, and the dangerous misuse of alternative therapies.
Hira Hareera still remembers the moment her baby arrived, like “a soap slipping from the hand.”
An acupuncturist from Malappuram in Kerala, she gave birth to her second child at home – without medical intervention or fear.
“I was tension-free, courageous. My mother cleaned my tiny human being and handed him over to me. I hugged him, took a bath, and walked to my bedroom,” she told South First. Moments later, she even took a selfie with her newborn son.
For Hira, the experience epitomised her trust in the body’s ability to heal and symbolised the support of her family – including her elder daughter and husband, who clipped the umbilical cord before she cut it herself.
Her son was born in a footling breech position – feet first – but she described the delivery as smooth and serene.
Yet when Hira decided to share her story publicly, she scarcely expected it would put herself and her family in legal trouble.
A retired clinical pharmacist and social activist from Malappuram, has filed a case against Hina.
Hamzath PM has been campaigning against the rise in unassisted home births in the district and argues that such deliveries are dangerous, and posts like Hira’s promote the unsafe practice.
And he was proven right soon after, when a 34-year-old Malappuram woman died giving birth at home.
The woman reportedly suffered heavy bleeding for three hours and delivered a 4.1 kg baby at home without medical support, despite having access to healthcare nearby.
The woman’s husband, Sirajudheen – a self-styled cleric and YouTuber who runs the channel Madavoor Qafila – was arrested and charged with culpable homicide not amounting to murder, and with destruction of evidence.
Kerala Health Minister Veena George condemned what she described as the concealment of women in need of medical attention, calling it a serious “criminal act”.
“Kerala has the lowest maternal and infant mortality rates, with advanced systems like genetic testing and newborn screening. It is unacceptable when people choose to avoid care,” she said.
“The police have registered a case, and we are taking this matter very seriously. I have called a meeting to analyse the legal issues involved in this.”
The minister revealed that roughly 400 home births take place annually in Kerala. So far in 2025, there have been 382 home deliveries out of approximately two lakh births, mostly in tribal regions and among migrant worker communities.
Officials have been instructed to carry out a detailed study to understand the reasons behind home births and to take appropriate steps based on the findings.
She also emphasised that denying medical treatment is a punishable offence.
Calling for a multi-pronged awareness campaign, she urged elected representatives, community leaders and cultural organisations to help educate the public about the risks of unassisted childbirth.
District authorities have been tasked with gathering accurate local data and developing targeted interventions.
The minister also directed health officials to take strict action against those spreading misinformation on platforms such as YouTube and other social media.
The meeting was attended by senior officials, including the Additional Chief Secretary of the Health Department, State Mission Directors of the National Health Mission (NHM) and the National Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy Mission (AYUSH Mission), and directors from various medical services.
A letter written by a woman consenting for home birth
Some individuals who opt for home births – including Hira – assert that such deliveries are not illegal and justify their decision to bypass the formal medical system.
Speaking to South First, both Hira and another woman from Malappuram, Nisha (name changed), said their decision to give birth at home was entirely their own, and not influenced by family or partners.
Hira referred to the Malayalam film Somante Krithav, which depicts a home birth, describing it as a normal portrayal.
“Hospitals often complicate minor issues and quickly recommend caesareans,” said Hira.
“At the time of the second delivery, I had learned about acupuncture and the body’s self-healing power through social media. I did not give any vaccinations to my baby and faced no medical issues after the home birth.”
She added that she obtained her baby’s birth certificate from the local panchayat, and declined support from Accredited Social Health Activist (ASHA) workers.
“I drafted and voluntarily signed an agreement stating that the home birth was my choice, a right protected under Article 21 of the Indian Constitution, which guarantees the right to life and personal liberty.”
Hira also voiced support for the arrested Sirajudheen. She maintains that the decision to give birth at home belongs solely to the woman.
“There was no documentation to prove Sirajudheen’s innocence at the time. That is why I prepared a signed document in advance, to safeguard my family in case any trouble arises. In the end, it all comes down to courage.”
Nisha shared a similar view.
“My first delivery was stressful for me and my family. But the home birth? We celebrated it like a wedding. I was even doing household chores within hours. It is really that simple. Our bodies are capable of healing, we do not always need doctors or needles,” she said.
Supreme Court lawyer Adv Babila Ummerkhan confirmed that Kerala’s birth registration system currently accepts “delivered at home” as a valid category, which, she said, enables families to avoid scrutiny even after risky or unlawful deliveries.
“Birth certificates in Kerala still allow ‘delivered at home’ as an option, which families use to evade scrutiny even after risky or illegal deliveries,” she said.
She argued that the rights of newborns, including access to timely medical care, are compromised and that authorities lack the legal tools to hold families accountable.
“There is no law in India that makes home births illegal, but the government and health officials strongly discourage them,” she said.
“The Indian government’s recommendation is that deliveries should be conducted by qualified medical professionals such as Bachelor of Medicine and Bachelor of Surgery (MBBS) doctors, midwives, staff nurses registered with the Indian Nursing Council, and auxiliary nurse midwives.
“Health departments have issued warnings against childbirth at home, citing the potential risks and dangers, and emphasising that any normal delivery can turn into a complication.”
Letter saying Acupuncture is not recognised in Kerala
Yet, criticism has continued to mount over a rise in home births in Malappuram.
The district recorded the highest number of home births in Kerala, with 1,244 out of 2,931 deliveries taking place at home between 2019 and September 2024.
Dr Prathibha K, a Medical Officer from Malappuram alleged the existence of underground birthing networks, including unlicensed centres and digital coordination through WhatsApp groups and rotating mobile numbers.
Women from across Kerala and even from Lakshadweep are reportedly brought to Malappuram for deliveries, sometimes paying as much as ₹5,000 for basic home birth “packages”.
Meanwhile, the rise of such home births are often linked with alternative medicine, particularly acupuncture.
But according, Dr Abdul Gafoor, President of the All-Kerala Association of Acupuncturists and a practitioner with 26 years of experience, the controversial cases being associated with acupuncture do not reflect authentic practices of the traditional Chinese technique.
“What is being portrayed as acupuncture is actually Onetex Therapy, a practice invented by Fazalu Rahman in Tamil Nadu, which later got loosely merged with acupuncture. Their concepts and practices are vastly different,” Dr Gafoor told South First.
He alleged that followers of this therapy are misusing the name of acupuncture while promoting unsafe methods.
“They discourage even basic diagnostic tests like blood tests and advise against emergency medical care. Some even attempt to treat critical conditions such as cardiac arrest or oversee childbirth using only their methods. This is not traditional Chinese medicine; it never promotes discontinuing emergency medicine,” he warned.
Dr Gafoor added that he has received threats online for speaking out against these practices.
“It is becoming like a network. These practices are a threat to public health. The government must step in with strict laws and launch awareness campaigns to protect people from falling into these traps,” he urged.
Although acupuncture is not currently recognised by the Kerala State Medical Council, Dr Gafoor pointed out that the Union government has recognised it as a mode of therapy and has introduced two regulatory criteria.
“There was a notification from the central government recommending that acupuncture be considered an allied therapy. While some associations protested the move, discussions are ongoing, and we are hopeful that it will be approved soon,” he added.
Amidst this growing movement, Dr Prathibha has filed a petition in the Kerala High Court, calling for clear legal guidelines and regulatory accountability over home births in the state.
Her petition highlights the growing concern over maternal and neonatal health risks, lack of legal clarity, and the denial of birth certificates due to insufficient documentation in unassisted deliveries.
“Some families claim emergency births en route to hospitals, but many of these are planned in secrecy,” she said.
Common motivations include fear of hospitals and caesareans, modesty, financial constraints, and conservative beliefs – even among well-educated families.
Dr Prathibha warned of serious complications in the absence of medical supervision, including seizures, infections, and maternal cardiac arrest.
She cited past cases of deaths and injuries in districts such as Thiruvananthapuram, Malappuram, Kollam, and Thrissur.
Meanwhile, ASHA workers in the state are actively campaigning against the practice, hosting awareness sessions.
“Yesterday we got a class from the Primary Health Centre (PHC) about risks of home birth. We have already started campaigns to spread awareness,” Sreedevi Vipin, an ASHA worker from Ernakulam, told South First.
“Hiding pregnancy is not a good practice. Sometimes people hide because of personal reasons, but it is rare in Ernakulam. No such cases have been reported in recent times.”
(Edited by Dese Gowda)
