The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS,
a homebirth midwife in Mountain View, CA
Homebirth - Safety and Benefits
Overview Articles
Homebirth Safety
Hospital Hazards
Other Homebirth Benefits
Legal and Political Aspects of Homebirth
FLASH!!!
The State of California acknowledges that homebirth is a safe choice!
"The midwifery model of care is an important option within
comprehensive health care for women and their families and should be
a choice made available to all women who are appropriate for and
interested in home birth."
Overview Articles
Summary of Critical Points from "Safety of Alternative Approaches to Childbirth" by Peter F. Schlenzka - A doctoral thesis comparing safety and costs of natural, out-of-hospital birth with in-hospital obstetric births. He finds out-of-hospital births to be slightly safer and significantly superior in terms of economic costs ($13 billion annually) and social costs (reduced incidence of birth trauma and bonding disorders).Why choose home birth? from the Home Birth Association of Ireland - a great overview article that addresses the specific safety concerns of "what if . . . . ?" for a variety of childbirth complications.
Is Homebirth for You? - 6 Myths About Childbirth Exposed - A pamphlet discussing why homebirth is safer than hospital birth for most healthy women. An online version of the booklet produced by Friends of Homebirth.
home birth: what are the issues? by sara wickham - a nice overview article.
Home birth a safe alternative: Midwives offer mothers-to-be more control
by Karyn Miller-Medzon
Boston Herald, Sunday, June 25, 2000 [My link was osbsolete;
please e-mail
me if you have a current link.]
Homebirth Safety
Outcomes of planned home births with certified professional midwives: large prospective study in North America [Full-text article]Kenneth C Johnson, senior epidemiologist, Betty-Anne Daviss, project manager
BMJ 2005;330:1416 (18 June), doi:10.1136/bmj.330.7505.1416
Conclusions: Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States. [NOTE - CPMs are equivalent to Licensed Midwives in some states.]
Homebirth is as safe or safer than hospital birth in most cases. In the early 1900's, obstetricians made a business decision to force women in the U.S. to give birth in hospitals, even though they knew that homebirth was safer.
Outcomes
of intended home births in nurse-midwifery practice: a prospective descriptive
study.
Murphy PA, Fullerton J
Obstet Gynecol 1998 Sep;92(3):461-470
CONCLUSION: Home birth can be accomplished with good outcomes under the care of qualified practitioners and within a system that facilitates transfer to hospital care when necessary. Intrapartal mortality during intended home birth is concentrated in postdates pregnancies with evidence of meconium passage.Meta-analysis of the safety of home birth
Birth 1997 Mar;24(1):4-13; discussion 14-6
Olsen O
What is the relative safety of homebirth compared with hospital birth? Ole Olsen, a researcher from the University of Copenhagen, recently examined several studies of planned homebirth backed up by a modern hospital system compared with planned hospital birth. A total of nearly 25,000 births from five different countries were studied.
The results: There was no difference in survival rates between
the babies born at home and those born in the hospital. However,
there were several significant differences between the two groups.
Fewer medical interventions occurred in the homebirth group. Fewer
home-born babies were born in poor condition. The homebirth mothers
were less likely to have suffered lacerations during birth. They
were less likely to have had their labors induced or augmented by medications
or to have had cesarean sections, forceps or vacuum extractor deliveries.
As for maternal deaths, there were none in either group.
The
Safety of Home Birth attended by a Direct-Entry Midwife - What Science
has to Say
Compiled by Michael J. Stark, Ph.D. for the Maryland Friends of
Midwives and now hosted by Midwives
on Missions of Service (MOMS), who have a
very helpful collection of homebirth safety information.
Citizens for Midwifery - FACT SHEET - The Safety of Homebirth
From a World Health Organization (WHO) report - subsection on Place
of Birth:
- It has never been scientifically proven that the hospital is a safer
place than home for a woman who has had an uncomplicated pregnancy to have
her baby. Studies of planned home births in developed countries with women
who have had uncomplicated pregnancies have shown sickness and death rates
for mother and baby equal to or better than hospital birth statistics for
women with uncomplicated pregnancies.
Excerpt from the World Health Organization's Summary
of Research on Place of Birth from Care
in Normal Birth: A Practical Guide Report of a Technical Working Group
From a report on homebirth in England:
- More recently, the 1992 House of Commons Select Committee on Maternity
Services, now known as the Winterton report, went to the heart of the issue
in the first of more than 100 recommendations and conclusions on pregnancy,
labour and postnatal care.
On the basis of what we have heard, this Committee must draw the conclusion that the policy of encouraging all women to give birth in hospitals cannot be justified on grounds of safety.
Elsewhere the report went further. "There is no convincing or compelling
evidence that hospitals give a better guarantee of the safety of the majority
of mothers and babies. It is possible, but not proven, that the contrary
may be the case."
A review of the literature regarding relative homebirth and hospital safety.
Meta-analysis of the safety of home birth. [Birth. 1997 Mar;24(1):4-13; discussion 14-6.]
Homebirth
Safety Research Abstracts
A collection of abstracts from studies regarding homebirth safety.
Isle of Man Study
A single abstract about a particularly convincing study.
Quality and Safety of Direct-Entry Midwifery Practice in the U.S. from the ACNM Resources & Bibliography Series
Home versus hospital deliveries: follow up study of matched pairs for procedures and outcome[from the BMJ]
Summary of Results of Matched Population Study Comparing Hospital Birth
with Home Birth
Summary of Results of Matched Population Study Comparing Hospital Birth
with Home Birth
Summary of epidemiologically controlled comparison
of home and hospital birth. Original study, by Mehl LE et al. Outcomes
of
elective home births: a series of 1.146 cases.
J Reprod Med 1977;19(5):281-90.[web page lost to web entropy - please e-mail
me if you come across this page anywhere on the web. Thanks.]
Mehl, L., Peterson, G., Shaw, N.S., Creavy, D. (1978) "Outcomes of
1146 elective home births: a series of 1146 cases." J Repro Med.
19:281-90
Neonatal Outcomes:
- In the hospital, 3.7 times as many babies required resuscitation.
- Infection rates of newborns were 4 times higher in the hospital.
- There was 2.5 times as many cases of meconium aspiration pneumonia in the hospital group.
- There were 6 cases of neonatal lungwater syndrome in the hospital and none at home.
- There were 30 birth injuries (mostly due to forceps) in the hospital group, and none at home.
- The incidence of respiratory distress among newborns was 17 times greater in the hospital than in the home.
- While neonatal and perinatal death rates were statistically the same for both groups, Apgar scores (a measure of physical well being of the newborn) were significantly worse in the hospital.
Editorial from the
British Medical Journal
This editorial advocates for homebirth and a supportive infrastructure.
It also has links to full-text articles affirming homebirth safety:
- Perinatal loss in planned and unplanned home birth. The Northern Region's Perinatal Mortality Survey Coordinating Group. BMJ 1996;313:1306-9.
- Home versus hospital deliveries: a prospective study on matched pairs. Ackermann-Liebrich U, Voegli T, Guenther-Witt K, Kunz I, Zullig M, Schindler C, et al. BMJ 1996;313:1313-8.
- Outcome of planned home and planned hospital births in low risk pregnancies in the Netherlands. Wiegers T A, Keirse M J N C, van der Zee J, Berghs G A H. BMJ 1996;313:1309-13.
- Prospective regional study of planned home birth. Davies J, Hey E, Reid W, Young G. BMJ 1996;313:1302-5.
Corroborating Citations on the Safety of Homebirth
The Newborn Immune System and Immunological
Benefits of Breastmilk
One of the least understood issues of homebirth safety is the low infection
risk. The exposure of the newborn to life-threatening infection that
occurs in the hospital is one of the leading causes of neonatal death.
The
Pang-Benedetti Study on Home-based Birth - Synopsis & Commentary:
How Asking the wrong questions gives you the wrong answers!
Hospital Hazards
Report Cites Deadly Medical Errors - Medical mistakes kill anywhere from 44,000 to 98,000 hospitalized Americans a year.Drug Administration Errors in Infants [Medscape registration is free.]
Hospital-Acquired Infections from emedicine.com "Within hours of admission, colonies of hospital strains of bacteria develop in the patient's skin, respiratory tract, and genitourinary tract."
Antibiotic-Resistant Infections - Recent News Reports
Antibiotic-Resistant Infections - Questions & Answers
Hospital-Acquired Infections and Antibiotic
Resistance - Notes and References
Other Homebirth Benefits
Homebirth provides many benefits beyond a safer birth. Some families choose homebirth because they believe that their home is the most appropriate place for a new baby to enter their family circle. Some families choose homebirth because they want control over all the circumstances of the birth, including who is present and what the caregiver does to the mother and baby.No Baby Mix-Ups - I used to think it was funny when people said one of the benefits of homebirth was that there was no chance of a baby mix-up . . . no chance of having some other mom nurse your baby, no chance of having your baby circumcised or vaccinated against your will because of a mix-up, and no chance of going home and raising the wrong baby. But it seems that the news lately is full of stories of such mix-ups, so I may as well list it here. - Calif. hospital admits 3 more baby mix-ups