Home Births Are Safe For Low-Risk Pregnancies

New findings published in the Canadian Medical Association Journal (CMAJ) show that women with low-risk pregnancies who plan to give birth at home with the help of a midwife should be safe-with no increased risk of harm to the baby when compared to a planned hospital visit.

"Among women who intended to birth at home with midwives in Ontario, the risk of stillbirth, neonatal death or serious neonatal morbidity was low and did not differ from midwifery clients who chose hospital birth," writes Dr. Eileen Hutton, Department of Obstetrics and Gynecology and the Midwifery Education Program, McMaster University, Hamilton, Ontario, with coauthors.

During the study, researchers compared over 11,000 planned home births to 11,000 planned hospital births in Ontario, Canada's largest province, over 3 years to determine the risk of stillbirth, neonatal death or serious events among low-risk women; this included first-time mothers (35 percent) and women who had previously given birth (65 percent).

In Ontario, about 10 percent of births are attended by midwives, and about 20 percent of these are at home.

Study findings showed that about 75 percent of women planned to give birth at home were safe to while 97 percent of potential mothers planning to give birth at home had their babies. On the other hand, for the planned hospital birth cohort, 8 percent needed emergency medical services, as did 1.7% in the planned hospital group. Women in the hospital group were more likely to have interventions such as labor augmentation, assisted vaginal births or cesarean deliveries. The incidence of stillbirth or neonatal death was 1.15 per every 1000 births in the planned home birth group compared with 0.94 per 1000 in the planned hospital birth group.

"Compared with women who planned to birth in hospital, women who planned to birth at home underwent fewer obstetrical interventions, were more likely to have a spontaneous vaginal birth and were more likely to be exclusively breastfeeding at 3 and 10 days after delivery," the study authors wrote. 

"As more women choose home birth and as the midwifery profession grows in Ontario, it will be interesting to see whether the lower intervention rates that have been consistently observed to date among women who plan home births are sustained."

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