Home Births With Certified Midwives Just as Safe as Hospitals

A new large prospective study in North America published in the June 18, 2005 British Medical Journal revealed that there was no difference in mortality rates between planned home births and hospital births for low risk women. The study found that “planned home births for low risk women in the United States are associated with similar safety and less medical intervention as low risk hospital births.”

The researchers followed 5418 women who intended to deliver at home at the start of labor, and compared them with all women who gave birth to a single normal delivery baby. In this group they found that rates of medical intervention for home births were consistently less than half of those in hospitals.

The reduction in medical intervention for some specific procedures was drastic in the low risk home birth group. Rates of electronic fetal monitoring was shown to be 9.6% for home births versus 84.3% in the general population of low risk hospital births. For caesarean section, the rate of those home births that had to be transported to the hospital and then received a caesarean was 3.7% versus 19.0% of the hospital low risk births. Additionally, rates for episiotomy was 2.1% for home births versus 33.0% in hospitals for the low risk groups.

In the study group no maternal deaths occurred. The study also noted that over 87% of mothers and their babies did not require transfer to a hospital. The study also noted that that an uncomplicated vaginal birth in a hospital in the United States cost on average three times as much as a similar birth at home with a midwife.

The researchers concluded, “Our study of certified professional midwives suggests that they achieve good outcomes among low risk women without routine use of expensive hospital interventions.” They went on to add, “Our results are consistent with the weight of previous research on safety of home birth with midwives internationally. This evidence supports the American Public Health Association’s recommendation to increase access to out of hospital maternity care services with direct entry midwives in the United States. We recommend that these findings be taken into account when insurers and governing bodies make decisions about home birth and hospital privileges with respect to certified professional midwives.”