Photo by Shutterstock

Although home birth frequency has increased within the last 20 years, very few women choose home sweet home as their baby’s birth place. In fact, a comprehensive study on home births notes that just 1.2 percent of all United States deliveries occur at home. This is strikingly different from other countries. 8% of women in Great Britain and 29% of women in the Netherlands have home births and they may be on to something good according to new research published this week in the Journal of Midwifery and Women’s Health. This study, the largest of its kind ever conducted in the United States, found that planned home births with midwives are safe as long as the mother-to-be is experiencing a low-risk pregnancy. The researchers found that 93.6% of the 16,924 women participating in the study had spontaneous vaginal births while only 5.2% required a cesarean section. Conclusions about home birth safety are less clear for higher-risk women, but the low-risk women involved in the study had high rates of normal birth and very low rates of operative birth and interventions, with no significant increase in adverse events. Mortality figures and the cesarean rates were found to be lower than those reported in U.S. hospitals, which is to be expected because as the researchers say, women in the home birth study were low-risk and healthy. But it’s important to also note that these home birth safety figures are consistent with home birth study findings in Canada and Europe. “Given our findings, especially in light of other observational studies published in the last decade, I think it’s time to start shifting the discourse around home birth in this country,” said Melissa Cheyney, a medical anthropologist at Oregon State University and lead author on the study. Cheyney added, “We need to start focusing on who might be a good candidate for a home or birth center birth and stop debating whether women should be allowed to choose these options.”

birth place,home childbirth,midwife,midwifery,perinatal outcome,pregnancy outcomes, home birth safe, home births, homebirth, home birth safety, home birth, low risk pregnancy
Photo by Shutterstock

The statistics for this study came from the Midwives Alliance of North American Statistics Project (MANA Stats) 2.0 data registry and boast some major home birth benefits and successes for both mamas and babies. Of the 16,924 women who planned home births, a full 89.1% ended up giving birth at home and most women were only transferred for failure to progress, not a major problem. Just 4.5% of these women required oxytocin augmentation and/or epidural analgesia. Even better, 1054 women who planned home births were also attempting a vaginal birth after cesarean (VBAC) and amazingly 87% were successful. Babies born at home fared very well too. Only 1.5% of all the newborns had low Apgar scores and postpartum maternal (1.5%) and neonatal (0.9%) transfers were very infrequent. On top of all of this good news for home birth advocates, most of the babies born at home (96%) were still breastfeeding at six weeks and of those 86% were exclusively breastfeeding, which is a much higher rate of breastfeeding success than the average. Right now, perinatal data is only available via birth certificates in the USA, which makes home birth research a challenge, plus of course, most women are against being randomized to a hospital or home birth in research studies. Still, while home birth data is still being assessed it’s clear from the research we do have available, that for low-risk women, home birth attended by a midwife should be considered a safe option. Cheyney sums up the research, noting, “Home birth is not for every woman and risk factors need to be weighed. But the evidence strongly suggests that a healthy woman with an uncomplicated delivery and a single, term baby in a head-down position can safely give birth outside the hospital.”

+ Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009

+ Study finds home births comparatively safe – for low-risk women, infants