Is homebirth safe?

A recent study sheds light on this question. The study is titled: “Outcomes of planned home births with certified professional midwives: large prospective study in North America.” Kenneth C Johnson (BMJ  2005;330:1416. Full text at: http://bmj.bmjjournals.com/cgi/content/full/330/7505/1416?ehom)

The study examined the births of 5418 women who were planning to deliver at home with one of 409 direct-entry midwives certified by the North American Registry of midwives.

Transfers: The majority of women who planned home births did birth at home. Among first-time moms, 25.1% transferred to the hospital, but only 6.3% of mothers who had birthed before required transfer. Half of the transfers were due to failure to progress, a desire for pain relief, or exhaustion. Very few of these transfers were urgent: only 3.4% of planned home births.

Interventions: Women who planned to birth at home were much less likely to experience medical interventions than similarly low-risk women birthing in hospitals. Planned home birth moms had a lower chance of episiotomy (2.1% vs. 33%), vacuum extraction (.6% vs. 5.5%), and cesarean (3.7% vs. 19%).

Outcomes: No maternal deaths occurred. The incidence of infant death was 1.7 deaths per 1000, which is within the range of observed rates for low risk hospital births.

Water birth: 12.8% of the babies (694 babies) were born in the water. There was one intrapartum death amongst these babies.

Health in the early weeks. Apgar scores: Only 1.3% of babies had Apgars below 7 at five minutes of age. By 6 weeks postpartum, 98.4% of mothers reported good health, and 98.3% of babies were in good health.

Breastfeeding. At six weeks, 95.8% of women were still breastfeeding their babies, 89.7% were exclusively breastfeeding. Nationwide, amongst primarily hospital-birth moms, 57.9% are breastfeeding at six weeks, and only 49.4% of those are exclusively breastfed. (CDC)

Satisfaction with caregiver. Researchers contacted 10% of the sample for information on this. 97% reported they were extremely satisfied or very satisfied. 89.6% of the mothers said they would choose the same midwife for their next birth, 9.1% would choose a different midwife, and only 1.7% would choose another type of caregiver.