Home Birth Safety: A Look at the Facts

Many women I know say they are considering having a home birth, but are afraid because "What if something happens?"

It is a generalized and unexamined fear that keeps women from birthing at home. It is a fear that has been fed to us by the medical establishment and the media.

Take a good look at your fear--what are you afraid of? There are no guarantees in life or in birth--not at home and not in a hospital.

Babies and mothers can and do die and suffer complications in the hospital just as well as at home.

Take a look at what constitutes a true birth emergency. Cord prolapse or a maternal hemorrhage would be examples of true emergencies. In these cases it would be prudent to go to the nearest hospital. But these incidences are relatively rare and in most cases action can be taken before it becomes a problem.

A good midwife will not accept a client that is high risk. That particular woman and her baby will need to give birth in the hospital. Some high risk situations include pre-eclampsia, pre-term labor (before 37 weeks), pre-existing conditions such as heart disease, kidney disease, or cancer.

But, for low risk women, having their baby at home is just as intelligent a choice as giving birth in a hospital.

Midwives are trained in normal birth and to spot impending complications before they occur. They carry equipment to deal with common complications, such as a baby that is slow to breathe, or a mother that is bleeding too much.

Midwives carry oxygen and resuscitation equipment, pitocin injections in case of hemorrhage, as well as the basic birth supplies of cord clamps and fetascope or doppler device to monitor the baby's heartbeat.

Midwives have better outcomes than obstetricians with same-risk patients.1

In Oregon from 1975-1979, there were roughly 3-4 neonatal deaths per 1000 births at home attended by midwives, and roughly 9-10 deaths per 1000 births for all residents.2

In the European countries with the lowest infant mortality rates, more than 70% of all births are attended by midwives. More than 50% of all babies born in the Netherlands are born at home with midwives in attendance, and the Dutch infant death rate is much lower than in the United States.3

It is very interesting that the year the American College of Obstetricians and Gynecologists was founded (1951), marked the beginning of a rise in the rate of infant mortality. The U.S. has not been above 16th place (meaning the 16th worse with 1st place being the lowest infant mortality) since 1975. 4

Take a look at Birth By the Numbers to see just how dismal the U.S fares in terms of birth outcomes. Obstetricians and hospitals are contributing greatly to poor birth outcomes.

Hospital birth with a doctor has never been shown to be safer than home birth with a trained and skilled midwife. In fact studies show home birth with a trained attendant to be just as safe as hospital birth.

The infant mortality and morbidity rates among low-risk mothers is about the same in home births as in hospital births. The rate of interventions used at home births is far far lower than the rate of interventions used in hospital births. This means that women who choose to birth at home, have far fewer inductions, augmentations, c-sections, episiotomies, vacuum or forceps extractions, and other invasive procedures.

Here is the link to one of the most recent studies on homebirth, done in 2005-- Outcomes of Planned Homebirths with Certified Professional Midwives: Large Prospective Study in North America.

Here is a fabulous article questioning the safety of hospital births.

1. (Madrona, Lewis & Morgaine, The Future of Midwifery in the United States, NAPSAC News, Fall-Winter, 1993, p.30)

2. (Research Issues in the Assessment of Birth Settings, Institute of Medicine, National Academy Press, Washington, 1982, p. 175)

3. ("Midwives Still Hassled by Medical Establishment," Caroline Hall Otis, Utne Reader, Nov./Dec. 1990, pp. 32-34)

4. (Stewart, David, International Infant Mortality Rates--U.S. in 22nd Place, NAPSAC News, Fall-Winter, 1993, p.38)

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