Home Births Do Not Lead to Increased Risk of Complications

Women with low-risk pregnancies who plan to give birth at home face no increased risk of harm to the baby compared to a planned hospital delivery, according to a new study.

Researchers at McMaster University (Hamilton, ON, Canada) conducted a study that compared 11,493 planned home births and 11,493 planned hospital births in Ontario, Canada's largest province, over a period of three years to determine the risk of stillbirth, neonatal death, or serious events among low-risk women. The study included both first-time mothers (35%) and women who had previously given birth (65%). About 75% of the women who planned to give birth at home was able to do so, as were 97% of those who planned to have a hospital birth.

The results showed that the overall incidence of stillbirth or neonatal death was 1.15 per every 1,000 births in the home birth group, compared with 0.95 per 1,000 in the hospital birth group. Among the women who planned a home birth, 8% needed emergency medical services, compared to 1.7% of those in the planned hospital group. Conversely, women in the hospital group were more likely to have medical interventions, such as labor augmentation, assisted vaginal births, or cesarean deliveries. The study was published on December 21, 2015, in the Canadian Medical Association Journal (CMAJ).

“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,” concluded lead author Eileen Hutton, BSc, MScN, PhD, and colleagues of the department of obstetrics and gynecology. “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.”

A home birth in developed countries using natural childbirth methods and takes place in a residence rather than in a hospital or a birth center; it is usually attended by a midwife or lay attendant with experience in managing home births. Since the beginning of the 20th century, home birth rates have drastically fallen in most developed countries, generally to less than 1% of all births. Infant and mother mortality rates have also dropped drastically over the same time period.

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