RESEARCH ON THE SAFETY OF HOMEBIRTH
To read the complete studies, click on the authors’ name(s)
A 5-year study comparing the outcomes of planned home births attended by midwives with those of planned hospital births attended by midwives or physicians.
A recent study of 5,418 women across North America giving birth at home with certified professional midwives which finds maternal and infant mortality rates matching those of low-risk women giving birth in the hospital, with a significant decrease in medical interventions: 12.1% of women planning to deliver at home were transferred to a hospital, and only 3.7% of the homebirth group were delivered via C-section.
– Johnson & Daviss, 2005
A study of 862 women in British Columbia which finds that the women planning to give birth at home by midwives were less likely to receive epidural anesthesia, undergo labor induction or augmentation, or receive an episiotomy than women giving birth in hospitals with either physicians or midwives. 6.4% of women planning homebirths were delivered via C-section, compared to 18.2% of women delivered by physicians in hospitals and 11.9% of women delivered by midwives in hospitals. There was no significant difference in maternal or neonatal mortality between the groups.
– Janssen et al., 2002
A study of 855 women in Zurich, Switzerland found that women delivering at home required significantly less pain medication and fewer medical interventions than women giving birth in the hospital, with no difference in duration of labor, lacerations during delivery or maternal blood loss. Babies born to both groups of women were no different in birth weight or clinical condition, but babies born at home were found to have slightly higher apgar scores.
– Ackermann-Liebrich et al., 1996
A study of 1836 women giving birth at home or in the hospital in the Netherlands found no difference between the groups in perinatal outcomes including fetal distress, newborn 5-minute apgar scores, perinatal death, operative or C-section deliveries. Multiparous** mothers giving birth at the hospital were more likely to have blood loss greater than 1000L and to require blood transfusions. In addition, babies from both primiparous* and multiparous mothers giving birth at the hospital were more likely to have problems within the first 24 hours after birth. Overall, multiparous mothers showed slightly better outcomes at home as compared to the hospital.
– Wiegers, Keirse, van der Zee & Berghs, 1996
A study of 976 women delivering at home and 2928 women delivering at the hospital in Western Australia found that the women giving birth at home were less likely to have labor induced or to have an operative delivery (C-section, forceps, vacuum extraction). Women giving birth at home were slightly more likely to have a postpartum hemorrhage or a retained placenta. Babies in the homebirth group were less likely to have a less-than-8 apgar score at five minutes or to have received resuscitation. In addition, postneonatal mortality was higher amongst babies in the hospital group.
– Woodcock, Read, Bower, Stanley & Moore, 1994
In the Farm Study, 1707 women delivered by lay midwives in a farming commune in Tennessee were matched with 14,033 physician-attended deliveries derived from the 1980 U.S. National Natality/National Fetal Mortality Survey. No significant differences were noted between the groups in terms of fetal and neonatal death, labor-related complication, or low 5-minute apgar scores. However, assisted deliveries (C-section, forceps, etc.) were much lower on the Farm compared to the hospital, with the Farm C-section rate at 1.46% versus the hospital’s 16.46% C-section rate.
– Durand, 1992
A recent study examined 5,762,037 live births and found that neonatal mortality rates were three times higher for babies born via C-section (1.77 per 1000 live births) compared to babies born via vaginal delivery (0.62 per 1000 live births). The two groups were statistically adjusted to rule out any medical risks that could increase the infant mortality rate not related to the mode of delivery.