Homebirth

Why Homebirth? Although the reasons for deciding to give birth at home vary, most families in this country who choose home birth share a belief that birth is a natural physiological process, not a medical condition which routinely needs intervention, and therefore can safely take place outside the hospital. Also common is the feeling that labor, birth, and early newborn / parent interaction are events which are facilitated and enhanced by the continuity, security, and familiarity of the home environment. In addition, for some families, the decision to birth at home may be driven by a desire to take greater personal responsibility for the entire birth experience. A wish for more decision-making authority is often a motivating factor when families have had a disappointing previous hospital experience and wish to have a more enjoyable subsequent birth. Whatever your reasons for considering home birth, you can rest assured that for healthy, low-risk women experiencing normal pregnancies, studies indicate that home birth with a trained attendant can be a safe option.

Safety of Homebirth

Virtually all well-designed* studies of planned home birth with a trained care provider have found that for healthy, low-risk women, home birth is as safe or safer than hospital birth. The World Health Organization, Midwives Alliance of North America, and the American College of Nurse Midwives all recognize attended home birth as a safe option for all low-risk women. To maximize the safety of home birth, a pregnant woman should be in good overall health and should maintain healthy habits and good nutrition during pregnancy. A home birth care provider should check for potential risk factors, and screen out women who have complications which might compromise the safety of home birth. The risk of some factors, such as vaginal birth after cesarean (VBAC) may be determined on an individual basis when compared to other factors (general well-being and health of the mother, reason for previous cesarean, etc.). For more information on Homebirth After Cesearean (HBAC) go here: http://www.rabn.org/pdf/HBAC.pdf    But remember, criteria for home birth may differ between providers. A Canadian study published in the British Medical Journal in 2005 showed that 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. It also showed that homebirth lowers the risk of cesarean. This supports the findings of all previous studies that were properly controlled*. Research from 2014 (Cheyney) found “Low-risk women  – – experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes”. A 2013 study from de Jonge, et al. published in the British Medical Journal found that complications were fewer in the homebirth setting than in the hospital setting. Also, two studies published in 2009, from the UK and Canada, and the Cochrane database review from 2012, also showed that homebirth with a registered Midwife was as safe for low risk women as a hopsital birth, with fewer interventions. Now, in 2016 ACOG (The American Congress of Obstetricians and Gynecologiss) released a new OPINION on homebirth.  They are getting closer to acknowledging the truth of the safety of homebirth, but they are still having difficulty admitting it. Be aware that ACOG is a trade union for Obstetricians.  They do not rule the industry, and can only suggest protocols.  They are in direct competition with Midwives, and homebirth, so be aware that their opinions are rather biased toward their business. The latest analysis of recent homebirth studies can be found on the Science & Sensibility website. Henci Goer reaffirmed what we already knew. * Well-designed studies compare low-risk women having planned, midwife-attended home births with low-risk women giving birth in hospitals.   Some poorly designed studies suggested that home birth was not safe, but these studies were done using raw data from birth certificates alone.  In those studies, all babies born outside a hospital or birth center, including unattended homebirths, unplanned homebirths, precipitous premature births, etc. were factored in when calculating morbidity and mortality rates, which alters the accuracy of the study. So in conclusion, as long as a woman is healthy and low risk, has planned the birth at home (as opposed to an emergency birth), and has hired a birth attendant (as opposed to unattended (in NY this would be a licensed Midwife) the statistics show that she can have a safe, healthy birth at home. Sources (Contact Amy Haas for a complete reference list at ajvhaas@gmail.com)