Home Birth: Safer Than You May Think

Healthnotes Newswire (October 8, 2009)—Giving birth in the hospital is a relatively new option. For most of our time on the planet, and still for much of the world, humans have given birth right at home. More recently, birth in developed countries has been moved to a hospital setting. While people are now accustomed to the more sterile environment, and are often reassured by having the equipment and staff on hand to mitigate complications, a new study published in the Canadian Medical Association Journal suggests that for women with low-risk pregnancies, there’s no place like home.

A team of researchers compared the safety of planned in-hospital births attended by physicians (5,331 women) or midwives (4,752 women) with planned home births attended by midwives (2,889 women). All of the women included in the study were eligible to have a home birth, meaning that they had no conditions that could put them at higher risk for complications, such as diabetes or heart disease.

While the rates of infant deaths were low in all the groups, they were lowest among those who planned a home birth, followed by those who planned a hospital birth attended by a midwife. Women who planned home births had significantly fewer interventions and complications than their hospital-birthing counterparts, including electronic fetal monitoring, assisted delivery, post-partum hemorrhage, and significant tearing. In addition, newborns in the home birth group were less likely to need resuscitation at birth or oxygen therapy beyond their first day, or to have meconium aspiration, a potentially serious problem affecting the lungs.

The big decision

Trang Duong, a US-trained midwife practicing in British Columbia who took part in the study explains, “Home birth is for low-risk pregnant women. In my practice, just because a woman wants a home birth, doesn’t mean she always gets one. We spend the entire pregnancy monitoring her pregnancy health and discuss the appropriateness and safety of home birth for her individual case. A woman has the right to choose her place of birth, but my job is to guide her safely in her choices. Sometimes that includes talking some women out of a home birth.”

When it comes to home birth safety, Duong says, “What few people are aware of, and this includes physicians who are against home birth, is that midwives attend home births well-equipped with emergency medical equipment, including oxygen, IV’s, and medications, and are able to initiate emergency procedures in a home birth setting. In British Columbia, midwives are required to recertify in emergency skills, including obstetrical skills and neonatal ,more frequently than physicians who attend births. Lastly, midwifery is so well integrated into the healthcare system here in BC that we have very good systems in place for the safe care of women and their newborns should transport to the hospital become necessary when a home birth is planned.”

The results of this study are similar to those of a previous study showing that home birth in the United States is at least as safe as hospital birth.

(CMAJ 2009;doi:10.1503/cmaj.081869)

Kimberly Beauchamp, ND, earned her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She cofounded South County Naturopaths in Wakefield, RI, and now sees patients in East Greenwich and Wakefield. Inspired by her passion for healthful eating and her own young daughters, Dr. Beauchamp is currently writing a book about optimizing children’s health through better nutrition.

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