Safe home births?

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When attended by a registered midwife, delivering a baby at home is a safe alternative to delivery in a hospital, according to a Canadian study.

The findings echo those of a Dutch study published in July that found that a planned home birth is as safe as a planned hospital birth, provided that a well-trained midwife is available, a good transportation and referral system is in place, and the mother has a low risk of developing any complications.

In the new study, Dr. Patricia A. Janssen, from the University of British Columbia, Vancouver, and colleagues looked at outcomes of all 2,889 planned home births attended by registered midwives in British Columbia from 2000 to 2004.

These outcomes were then compared with those of 4,752 hospital births attended by the same midwife group and those of 5,331 physician-attended hospital births.

Janssen and colleagues report that the infant death rate following planned home birth attended by a registered midwife did not differ from that of a planned hospital birth.

The infant death rate per 1000 births was 0.35 for planned home births compared to 0.57 for midwife-attended hospital births and 0.64 for physician-attended hospital births.

In addition, women in the planned-home birth group were less likely than those in the midwife-attended hospital birth group to have electronic fetal monitoring, assisted vaginal delivery, significant tearing around the birth canal, and bleeding after delivery. Similar findings were seen when home births were compared with physician-attended hospital births.

Infants born at home were less apt to require resuscitation and oxygen therapy beyond 24 hours, relative to both types of hospital birth, although they were more likely to be admitted to the hospital.

In a related commentary, midwife Helen McLachlan from La Trobe University, Bundoora, Australia and a co-author say this study "makes an important contribution to our knowledge about the safety of home birth."

They call for more evidence, ideally through randomized controlled trials.

Have you had a home birth? What was your experience?
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