Home Birth Safety

Here is a link to a Journal of Perinatal Education document called Birth Can Safely Take Place at Home and in Birthing Centers.

The abstract of the document says:

Although most women in the United States give birth in hospitals, a substantial body of research suggests that planned home birth or birth in freestanding birth centers have equally or better outcomes for low-risk women. Out-of-hospital birth often facilites mother-friendly care. Rationales and systematic reviews of both home birth and freestanding birth center birth are presented.

And only a few days ago the results of a very large study from the Netherlands was released. Here is the abstract from that study:

Objective To compare perinatal mortality and severe perinatal morbidity between planned home and planned hospital births, among low-risk women who started their labour in primary care.

Design A nationwide cohort study.

Setting The entire Netherlands.

Population A total of 529 688 low-risk women who were in primary midwife-led care at the onset of labour. Of these, 321 307 (60.7%) intended to give birth at home, 163 261 (30.8%) planned to give birth in hospital and for 45 120 (8.5%), the intended place of birth was unknown.

Methods Analysis of national perinatal and neonatal registration data, over a period of 7 years. Logistic regression analysis was used to control for differences in baseline characteristics.

Main outcome measures Intrapartum death, intrapartum and neonatal death within 24 hours after birth, intrapartum and neonatal death within 7 days and neonatal admission to an intensive care unit.

Results No significant differences were found between planned home and planned hospital birth (adjusted relative risks and 95% confidence intervals: intrapartum death 0.97 (0.69 to 1.37), intrapartum death and neonatal death during the first 24 hours 1.02 (0.77 to 1.36), intrapartum death and neonatal death up to 7 days 1.00 (0.78 to 1.27), admission to neonatal intensive care unit 1.00 (0.86 to 1.16).

Conclusions This study shows that planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives and through a good transportation and referral system.

Dr. Rixa Freeze's Stand and Deliver blog contains some comments and links to news stories about this study.