Home births are as safe as hospital

Published on Monday 28 September 2009 23:30

GIVING birth at home is as safe as doing so in hospital with a midwife, according to major new research.

The Canadian study of thousands of births found that women who planned a home birth had a lower risk of interventions, providing further credence to the arguments put forward by advocates of home birthing.

The issue remains controversial in Britain and further afield, with few women in Scotland opting to have their child at home. The most recent figures show that just 1.5 per cent of births in Scotland take place in the home.

However, the new research, carried out by staff at the University of British Columbia, is the latest in a series of studies to dismiss any health risks associated with home births.

The study's authors compared three different groups of planned births from 2000 to 2004 – home births attended by midwives, hospital births with midwives, and hospital births attended by physicians. In all, more than 13,000 births were looked at.

The researchers found the mortality rate per 1,000 births was 0.35 in the home birth group, whereas it was 0.57 and 0.64 in the latter two categories.

It also claims that women who opt for home births are less likely to have complications such as haemorrhaging or vaginal tearing, and their babies are less likely to require oxygen therapy or resuscitation.

Study author Dr Patricia Janseen said: "Newborns born after planned home births were at similar or reduced risk of death, although the likelihood of admission to hospital was higher.

"Women planning birth at home experienced reduced risk for all obstetric interventions measured, and similar or reduced risk for adverse maternal outcomes.

"They had a significantly lower risk of obstetric interventions and adverse outcomes, including augmentation of labour, electronic foetal monitoring, epidural analgesia, assisted vaginal delivery, Caesarean section, haemorrhage, and infection."

However, Dr Janssen admitted that the positive results could well be down to the type of women choosing home birth.

She said: "We do not underestimate the degree of self-selection that takes place … this may be an important component of risk management for home birth."

Both the Royal College of Obstetrics and Gynaecology and the Royal College of Midwives support home birth for women with uncomplicated pregnancies.

Sue Jacobs, a midwife teacher at the Royal College of Midwives, said: "Two generations have been socialised into giving birth in hospitals, but this study shows that low-risk mothers do not need to be in hospital.

"We are wasting a lot of resources by not encouraging more home births. It is something which helps the attachment between the mother and the baby, and is a social event."

Dr Helen McLachlan, a midwife and co-author of the report, which was published in the Canadian Medical Association Journal, said: "Given the current lack of evidence from randomised controlled trials, the study makes an important contribution to our knowledge about the safety of home birth."

CASE STUDY

ERIN Caithness was recently filling out a baby record book for her son, Oakley, when she realised something "kind of neat" – the entry for her son's place of birth was the same as the first family home.

Mrs Caithness, 32, gave birth to Oakley in February this year in the living room of her one-bedroom flat in Edinburgh.

She and her husband, Graham, wanted to make the experience as "comfortable" as possible, and in the end, a home birth seemed the best option.

"Giving birth was an issue of where I felt most comfortable. The more relaxed you are, the more positive the experience will be."

She also felt that by having Oakley at home, there would be less intervention.

"There are time constraints in hospital. To an extent they are watching the clock and thinking about jumping in," she added.

The primary school teacher said she met with midwives to fully understand the process, and agreed with the study's caveat about "self-selection". "Education is definitely a part of it," she said.

Not everyone agreed with her decision – one obstetrician called it "negligent".

But after a "very quick" labour, she knew she had made the right move.

"Two other mothers have since given birth in our pool," she said. "I'm a real advocate for home births."