Numerous studies have shown that home birth is safe for most women.
In fact, research shows that homebirth can be a safer option than a hospital delivery for low-risk women!
Studies showing it's unsafe tend to group unplanned or emergency home deliveries into their data on “out of hospital births.” In other words, they're not studying planned home deliveries… they're studying anyone that happened to give birth before she got to the hospital (even if it's in her car!).
Low-risk women who prepare and develop birth skills have very good outcomes.
Recent studies confirming the safety of birth at home have been published in the British Medical Journal and other leading journals.
One 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 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 (3).
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Excellent Outcomes from Fewer Restrictions
All recent studies have shown that planned home births in low-risk women have excellent outcomes. Homebirth may be safer than hospital childbirth. Many routine interventions, such as induction, continuous fetal monitoring, confining to bed, limiting foods, etc. lead to fetal distress and maternal complications.
You have no restrictions on eating or drinking at home. You eat or drink what your body needs and keep up your strength. You have no IV, so there are no uncomfortable needles or cumbersome bags and poles.
You get up and walk around. There's no fetal monitor forcing you to stay in bed on your back – a position that most women find painful (and compromises the oxygen your baby receives).
You can walk, lean, squat, or rest on all fours. You can go outside or come inside. You can take a shower or a bath.
You Must be Prepared
Studies show that healthy moms have good home births — and that skilled women have excellent births. Read books and take prepared childbirth classes – they'll 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.
Birth skills give you the confidence that you need for informed, relaxed childbirth. What you've discovered during pregnancy comes to you automatically during labor (and with help from your partner) and helps you cope with possible pain and natural labor progress calmly.
Safer for You and Baby
During your home birth, your midwife or midwife team is focused solely on you. There are no nurses rushing back and forth trying to monitor a whole floor. Your midwife is there for you as much as you need her – and she's as hands off as you want her to be. You can also choose an unassisted birth if that's what feels right to you.
You won't have many (and chose choose not to have any) 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.
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.
You won't be yelled at to push before you're ready or when your body is giving you a natural break (there are usually a few minutes between pushing contractions). Your midwife can support the tissues of your perineum and encourage you to deliver slowly and gently. You can let your body do the pushing – only pushing when it's irresistible.
Most midwives don't do routine episiotomy. These factors mean that homebirth is generally safer for your perineum. Research shows that natural tearing heals better than episiotomy.
Your baby is all yours – you can check your baby out for a moment before lifting him/her up, or bring your baby right to you. It's your choice in a home birth.
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 sweet time of uninterrupted bonding 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 are monitored, but left alone to bond. The newborn exam occurs awhile (even the next day) after the baby is born, giving 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. Some higher risks are pre-eclampsia, IUGR, 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 advised against home birth (4).
It's 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). Talk to your midwife and other moms who have experienced these situations – a home birth may very well be a great option for you.
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 a challenging situation, or who is willing to transport for the safety of you and/or baby.
Remember, too, that planned unassisted homebirths are generally very safe too. Go into any birth with awareness and good prenatal care (self-care counts).
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's 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 they show that homebirth is safe for low-risk women.
A Change in Paradigm
Homebirth is as safe or safer than a hospital birth for low-risk mothers, and well-planned research backs that up.
A good birth, however, goes beyond research. You and your baby are not lab rats, you're human beings working together for a good, safe birth. I encourage you to consider an additional paradigm for homebirth safety. Maryn Leister discusses this in the “Is Homebirth Safe?” episode of her podcast. A “paradigm” is your view, or perspective on something.
What makes birth safe is you. I began this article by noting that as a prepared mom you have a great chance at a good outcome. It's not statistics that make homebirth safe. It's mothers knowing that this is the right choice for them, and doing the work they need to do before birth. This varies between moms, because we all have different life experiences. But you can and should fully own your birth, and you can and should fully prepare for birth. You choose where you want to birth, who you want to attend you, and how you have your baby. Your knowledge and preparation help you choose the best place to birth your baby <3
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): 14162. 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.
2. 1997 Family Planning Perspectives
3. View the Farm's home birth statistics. Please see also the books [raw]
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).
5. “Is Homebirth Safe?” Taking Back Birth Episode
Photo by eyeliam