Natural Birth and Baby Care.com

Is Home Birth Safe?

Numerous studies have shown that for low-risk women home birth is indeed a safe choice.

In fact, some studies have show that a homebirth can be a safer option than a hospital delivery for low-risk women.

Studies that show that it's unsafe are usually found to be grouping unplanned or emergency home deliveries into their data on "out of hospital births."

The research is up to date

Just within the last few years (2005) a study confirming the safety of birth at home was published in the British Medical Journal.

This study examined women choosing to birth at home with a CPM, or certified professional midwife, in attendance. The results of the study were that homebirth is indeed safe, and 97% of the women participating in the study said they were highly satisfied with their homebirth (1).

A 1997 report in Family Planning Perspectives summarized four recent studies proving the safety of homebirth for low-risk women (2).

The Farm in Summertown, Tennessee, has been reporting excellent homebirth outcomes for decades. Their story and statistics are quite fascinating! I highly recommend their two books Spiritual Midwifery and Ina May's Guide to Childbirth (3).

Excellent outcomes

All recent studies have shown that planned home birth in low-risk women have excellent outcomes. A homebirth may indeed be safer than a hospital birth. At home, a women does not have to deal with routine interventions that might compromise her and her baby.

If you are in labor at home, you have no restrictions on eating or drinking. You are allowed to consume what your body needs, thus keeping up your strength. You have no IV, so there are no uncomfortable needles or cumbersome bags and poles.

You can get up and walk around as you please. There is no fetal monitor forcing you to stay in bed on your back - a position that most women find painful. It can also compromise the oxygen your baby receives.

You can walk, you can lean, you can squat, you can rest on all fours. You can go outside or come inside. You can take a shower or a bath.

Take the time during pregnancy to learn specific techniques to use at home. The Pink Kit will teach you how to know your own body and how you and your partner can work together to have the best birth. You'll learn skills that will truly help you as you labor at home. I highly recommend it.

During your home birth, your midwife or midwife team are focused solely on you. There are no nurses rushing back and forth trying to monitor a whole floor. Your midwife will be there for you as much as you need her - and she will be as hands off as you want her to be.

While you are at home, you probably won't have many internal exams. This lessens the chance of an infection being introduced to your baby. It also takes the focus off the measurement of your cervix and puts it on you.

There is no clock to go by at home. You can let your labor and your baby take the time that they need. Your midwife is much less likely to get antsy about time and order assisted delivery.

At home, you don't have the option of an epidural or spinal (or most forms of pain medication.) This is better for your baby. Though many say that these drugs have no effect on the baby, the evidence certainly shows that they do.

While you push your baby out at home, you probably won't be shouted at and encouraged to push quickly and before you are ready. Your midwife will support the tissues of your perineum and encourage you to deliver slowly and gently.

Most midwives don't do routine episiotomy. These factors mean that homebirth is generally safer for your perineum. If you do tear, it will probably be minor. Research shows that natural tearing heals better than episiotomy.

Once your baby is born he will probably be put right on your chest. If your baby needs help breathing, your midwife will have infant resuscitation equipment and she will be certified in neonatal resuscitation.

Your midwife will probably wait for your baby's cord to stop pulsing (unless it is tightly wrapped around his neck and needs to be cut right away.) This allows all the oxygen rich blood to reach your baby.

You and your baby will have your first magical moments together uninterrupted. Nursing can start right away or soon after. This quick nursing stimulates your uterus to contract.

As you go through the third stage of labor, your contracting uterus helps the placenta shear off cleanly from the side of the uterus. Your midwife won't yank the cord as might happen in the hospital. Yanking on the cord can cause it or the placenta to break, and it can cause postpartum hemorrhage.

You and your baby will be monitored, but left alone to bond. The newborn exam will probably occur awhile after the baby is born, to give the two of you (and the rest of the family!) the time you need to bond. You can rest assured that there are no strange hospital germs wandering around your home. Your body and your baby are used to your environment.

A home birth is a safe, wonderful option.

A note of caution

Studies proving that homebirth are safe have the results they do because it is low-risk women who are home birthing. A knowledgeable midwife will know when she needs to "risk a client out." This means that she advises delivery at a hospital because a woman has factors that constitute obstetrical risk. She is at higher risk for problems during delivery.

Some of these risks are pre-eclampsia, or a pre-existing medical condition. An Australian study showing unfavorable outcomes for homebirth concluded that many of the women who attempted homebirth should have been risked out (4).

It is important to take excellent care of yourself during pregnancy. Being responsible for your own good care, eating an excellent diet, and preparing yourself are the best ways to help you stay low-risk for a home birth.

Some controversial "risks" are home birth for breech babies, twins, and VBACs (vaginal birth after cesarean). You will want to talk with your midwife and do more research.

Having a good, open communication with your midwife about all your pregnancy issues can help assure that you have the wonderful homebirth you dream of. Be sure you've chosen a midwife that you feel confident can handle any emergency or transport need that may arise.

Emergency Deliveries skew results

Unplanned home deliveries having bad outcomes often find their way into "home birth" statistics. If you hear of a report showing that homebirth is unsafe it is good to ask where the sample was drawn from. Often the researchers have only gone over reports of "out of hospital births" and not made a distinction between planned home birth and accidental home delivery.

If the accidental home deliveries are removed from these studies it almost always proves that again, homebirth is safe for low-risk women.

Homebirth is Safe!

Homebirth is a wonderful thing for both mother and child. It is as safe or safer than a hospital birth for low-risk mothers. Your homebirth can be one of the most rewarding experiences of your life. It gives you and your baby a wonderful, wonderful start in life.

1. Kenneth C. Johnson and Bette-Anne Daviss, "Outcomes of Planned Home Births with Certified Professional Midwives: Large Prospectus Study in North America," British Medical Journal 330 (18 June 2005): 1416

2. L. Remez, "Planned home birth can be as safe as hospital delivery for women with low-risk pregnancies," Family Planning Perspectives May-June 1997 v29 p(141)3.

3. View the Farm's home birth statistics. Please see also the books Spiritual Midwifery and Ina May's Guide to Childbirth.

4. Hilda Bastian, Marc J.N.C Keirse and Paul A.L. Lancaster, "Perinatal Death Associated with Planned Home Birth in Australia: Population Based Study," British Medical Journal August 8th, 1998 v317 n7155 p384(5).