Study: Planned Home Birth Safe as Hospital Birth
Reported September 02, 2009
(Ivanhoe Newswire) — While the debate about the safety of home births drones on, a new Canadian study has found that a baby will be as safe during a planned home birth attended by a registered midwife is as he or she would be in a planned hospital birth.
American, Australian and New Zealand Colleges of Obstetricians and Gynecologists oppose home births, while the United Kingdom’s Royal College of Obstetrics and Gynecology and the Royal College of Midwives are supportive, as are midwife organizations in Canada, Australia and New Zealand. Canada’s Society of Obstetricians and Gynecologists has called for further research into the safety of home birth, and this study addresses that directive.
Researchers looked at 2,889 home births attended by regulated midwives in British Columbia, Canada, and at 4,752 planned hospital births attended by the same cohort of midwives, compared with 5,331 physician-attended births in hospital.
Researchers found women who planned a home birth had a significantly lower risk of obstetric interventions and adverse outcomes, including augmentation of labor, electronic fetal monitoring, epidural analgesia, assisted vaginal delivery, cesarean section, hemorrhage and infection.
“Women planning birth at home experienced reduced risk for all obstetric interventions measured, and similar or reduced risk for adverse maternal outcomes,” Dr. Patricia Janssen from the University of British Columbia and coauthors are quoted as saying. Newborns born after planned home births were at similar or reduced risk of death, although the likelihood of admission to hospital was higher.
Factors in the home environment that decrease risks are not well-understood and could be due to sample bias. “We do not underestimate the degree of self-selection that takes place in a population of women choosing home birth. This self-selection may be an important component of risk management for home birth,” the researchers wrote. “The eligibility screening by registered midwives safely supports a policy of choice in birth setting.”
“Our population rate of less than one perinatal death per 1,000 births may serve as a benchmark to other jurisdictions as they evaluate their home birth programs,” the authors concluded.
In a related editorial, midwife and coauthor Helen McLachlan, Ph.D., from La Trobe University, Bundoora, Australia wrote, “Given the current lack of evidence from randomized controlled trials, the study by Janssen and colleagues makes an important contribution to our knowledge about the safety of home birth. As with most studies of home birth, their study was limited by the possibility – if not likelihood – of self-selection by participants to a home birth option.”
SOURCE: Canadian Medical Association Journal (CMAJ), August 31, 2009