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Study: Planned Home Birth Safe as Hospital Birth
Reported September 02, 2009
(Ivanhoe Newswire) -- While the debate about the safety of home
births drones on, a new Canadian study has found that a baby will be as safe
during a planned home birth attended by a registered midwife is as he or she
would be in a planned hospital birth.
American, Australian and New Zealand Colleges of Obstetricians and
Gynecologists oppose home births, while the United Kingdom's Royal College
of Obstetrics and Gynecology and the Royal College of Midwives are
supportive, as are midwife organizations in Canada, Australia and New
Zealand. Canada's Society of Obstetricians and Gynecologists has called for
further research into the safety of home birth, and this study addresses
that directive.
Researchers looked at 2,889 home births attended by regulated midwives in
British Columbia, Canada, and at 4,752 planned hospital births attended by
the same cohort of midwives, compared with 5,331 physician-attended births
in hospital.
Researchers found women who planned a home birth had a significantly lower
risk of obstetric interventions and adverse outcomes, including augmentation
of labor, electronic fetal monitoring, epidural analgesia, assisted vaginal
delivery, cesarean section, hemorrhage and infection.
"Women planning birth at home experienced reduced risk for all obstetric
interventions measured, and similar or reduced risk for adverse maternal
outcomes," Dr. Patricia Janssen from the University of British Columbia and
coauthors are quoted as saying. Newborns born after planned home births were
at similar or reduced risk of death, although the likelihood of admission to
hospital was higher.
Factors in the home environment that decrease risks are not well-understood
and could be due to sample bias. "We do not underestimate the degree of
self-selection that takes place in a population of women choosing home
birth. This self-selection may be an important component of risk management
for home birth," the researchers wrote. "The eligibility screening by
registered midwives safely supports a policy of choice in birth setting."
"Our population rate of less than one perinatal death per 1,000 births may
serve as a benchmark to other jurisdictions as they evaluate their home
birth programs," the authors concluded.
In a related editorial, midwife and coauthor Helen McLachlan, Ph.D., from La
Trobe University, Bundoora, Australia wrote, "Given the current lack of
evidence from randomized controlled trials, the study by Janssen and
colleagues makes an important contribution to our knowledge about the safety
of home birth. As with most studies of home birth, their study was limited
by the possibility – if not likelihood – of self-selection by participants
to a home birth option."
SOURCE: Canadian Medical Association Journal (CMAJ), August 31, 2009 |
