Overview Articles

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

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.

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."
 

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 Farm" Bibliography

Yet more references

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

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

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

Lots of links about Babies Switched at the Hospital

There’s no Place Like Home - The advantages – and joys – of giving birth where you live By Pam England, author of Birthing From Within

Smarter Babies - Mom's Nurturing Boosts Baby's Brain - maternal nurturing is vital to the development of babies' brains.  [Dr. Michael Meaney of McGill University, Nature Neuroscience, August, 2000]  Homebirth fosters unmedicated births so both mom and baby have high levels of endorphins, the bonding hormones, at birth.  Homebirth supports continuous contact between mother and newborn, thereby facilitating breastfeeding and all aspects of maternal nurturing.  [Read more about bonding and the effects of the birth experience on newborn development.]

Kate Weber Brown's Homebirth pages.  [These pages have been moved. Please e-mail me if you know their current location.  Thanks.]
A Web page written by parents who were surprised to find themselves choosing homebirth as their safest option. My favorite over-all homebirth URL for non-professionals.

Why families choose homebirth

Labor of Love - Some more wonderful birth stories

A Comment on Natural Childbirth, including mention of the "Steiger curve" of penile performance.

Unassisted Birth Stories
I wouldn't recommend unassisted birth for most people, but these stories emphasize just how normal and safe birth really is. And if it's safe without any assistance, imagine how much safer it would be with a trained birth attendant ready to handle any emergencies.

Paper on Infant Pain
Search for the section heading - Birth Has Become More Painful For Babies and the subheading: The pain of hospital birth.

The earlier an infant is subjected to pain, the greater the potential for harm. Early pains include being born prematurely into a man­made "womb," being born full­term in a man­made delivery room, being subject to any surgery (major or minor), and being circumcised. We must alert the medical community to the psychological hazards of early pain and call for the removal of all man­made pain surrounding birth.

More information about Bonding and Birth Trauma

Violent deliveries may lead to violent ends
LONDON (Reuters) - A person who starts life with a traumatic and painful birth is more likely to end it with a violent suicide, Swedish researchers said Friday. Their study of adults who committed suicide in Sweden showed how people are born may be linked to how they chose to die. Complications during birth, long labor, a breech position and the use of forceps and suction were associated with an increased risk of violent suicide for adult men. The pain the infant experienced also was an important factor.

Legal and Political Aspects of Homebirth

Home Sweet Homebirth: The Video - A fascinating documentary of the history of midwives from antiquity to the present day.  Includes interviews with noted doctors and historians  and many people who have experienced a home birth  for themselves.

The British Maternity Charter
In England, homebirth is a fully integrated aspect of their national health care. Women are routinely offered the option of choosing homebirth.

A British Homebirth Support Group