Home Birth as Safe as Hospital Delivery for Low-Risk Pregnancies

Home Birth as Safe as Hospital Delivery

for Low-Risk Pregnancies

Reuters Health Information 2005. © 2005 Reuters Ltd.


NEW YORK (Reuters Health) Jun 16 – Planned home births for low risk women using

certified professional midwives are no more likely than hospital births to result in

intrapartum and neonatal mortality, according to a report in the June 18th issue of the

British Medical Journal. Moreover, the good outcomes are achieved using fewer

medical interventions.

Dr. Kenneth C. Johnson, with the Center for Chronic Disease Prevention and Control,

and Dr. Betty-Anne Daviss, with the International Federation of Gynecology and

Obstetrics, both in Ottawa, Canada, conducted what they believe to be the largest

prospective study of planned home births to date.

Included were 5418 women in Canada and the US who planned to deliver at home in

the year 2000 using certified midwives. The authors compared outcomes for these

women with more than 3 million in-hospitai births in the US in 2000.

A total of 655 women (12.1%) were transferred to a hospital. Excluding deaths of babies

with fatal birth defects, the rate of intrapartum and neonatal mortality was 1.7 deaths per

1000 births, “similar to risks in other studies of low-risk home and hospital births in North

America,” the authors write.

The rate of medical interventions was less than half of that observed in the comparison

group. For instance, 2.1% of those in the home delivery group underwent episiotomy,

compared with 33.0% of those in the control group. Similarly, rates of forceps delivery

(1.0% versus 2.2%), vacuum extraction (0.6% versus 5.2%), and caesarean section

(3.7% versus 19.0%) were lower in the home delivery group.

The authors contacted approximately 10% of mothers to verify outcomes and to

question them regarding their satisfaction with care. For all 11 questions, over 97%

reported that they were “extremely or very satisfied.”

These findings “support the American Public Health Association’s recommendation to

increase access to out of hospital maternity care services with direct entry midwives in

the United States,” Dr. Johnson and Dr. Daviss conclude.

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