Is Home Birth Safe?

There have been numerous studies on the safety of home birth. Read below (or click on the title link) to see the results.

Another great resource for legitimate studies on all things birth related is Evidence Based Birth. You will find articles in plain language that help to understand the statistics for everything from Vitamin K to GBS to Advanced Maternal Age. Just search the topic of interest.

United States Home Birth Study – 2004-2009

Results

Among 16,924 women who planned home births at the onset of labor, 89.1% gave birth at home. The majority of intrapartum transfers were for failure to progress, and only 4.5% of the total sample required oxytocin augmentation and/or epidural analgesia. The rates of spontaneous vaginal birth, assisted vaginal birth, and cesarean were 93.6%, 1.2%, and 5.2%, respectively. Of the 1054 women who attempted a vaginal birth after cesarean, 87% were successful. Low Apgar scores (< 7) occurred in 1.5% of newborns. Postpartum maternal (1.5%) and neonatal (0.9%) transfers were infrequent. The majority (86%) of newborns were exclusively breastfeeding at 6 weeks of age. Excluding lethal anomalies, the intrapartum, early neonatal, and late neonatal mortality rates were 1.30, 0.41, and 0.35 per 1000, respectively.

Discussion

For this large cohort of women who planned midwife‐led home births in the United States, outcomes are congruent with the best available data from population‐based, observational studies that evaluated outcomes by intended place of birth and perinatal risk factors. Low‐risk women in this cohort experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes.

 

Cohort Study – 2014

Setting The Netherlands.

Population Low‐risk women in midwife‐led care at the onset of labour.

Methods Analysis of national registration data.

Main outcome measures Intrapartum and neonatal death, Apgar scores, and admission to a neonatal intensive care unit (NICU) within 28 days of birth.

Results

Of the total of 814 979 women, 466 112 had a planned home birth and 276 958 had a planned hospital birth. For 71 909 women, their planned place of birth was unknown. The combined intrapartum and neonatal death rates up to 28 days after birth, including cases with discrepancies in the registration of the moment of death, were: for nulliparous women, 1.02‰ for planned home births versus 1.09‰ for planned hospital births, adjusted odds ratio (aOR) 0.99, 95% confidence interval (95% CI) 0.79–1.24; and for parous women, 0.59‰ versus 0.58‰, aOR 1.16, 95% CI 0.87–1.55. The rates of NICU admissions and low Apgar scores did not significantly differ among nulliparous women (NICU admissions up to 28 days, 3.41‰ versus 3.61‰, aOR 1.05, 95% CI 0.92–1.18). Among parous women the rates of Apgar scores below seven and NICU admissions were significantly lower among planned home births (NICU admissions up to 28 days, 1.36 versus 1.95‰, aOR 0.79, 95% CI 0.66–0.93).

Conclusions

We found no increased risk of adverse perinatal outcomes for planned home births among low‐risk women. Our results may only apply to regions where home births are well integrated into the maternity care system.”

The Safety of Home Birth: The Farm Study

Pregnancy outcomes of 1707 women, who enrolled for care between 1971 and 1989 with a home birth service run by lay midwives in rural Tennessee, were compared with outcomes from 14,033 physician-attended hospital deliveries derived from the 1980 US National Natality/National Fetal Mortality Survey. Based on rates of perinatal death, of low 5-minute Apgar scores, of a composite index of labor complications, and of use of assisted delivery, the results suggest that, under certain circumstances, home births attended by lay midwives can be accomplished as safely as, and with less intervention than, physician-attended hospital deliveries.

 

Benefits of having a trained doula:

45% reduction in cesarean births
25% shorter labor
60% reduction in epidural requests
50% reduction in oxytocin use
30% reduction in analgesic use
34% reduction in forceps delivery