Birthplace Study | Women's Health Blog

Date: 12/17/2011    Written by: Beth Levine

Safe at Home Birthing

Giving birth to a child in the warm, comfortable surroundings of your own home sounds like a wonderful option to many women.  It can certainly hold more appeal than the typical option of the cold and impersonal delivery rooms found in most hospitals.  Yet few women choose home delivery because of the fear that it might be dangerous, a view which is fostered by many in the medical community who are resistant even to the suggestion of a home birth.

However, now there is new research that suggests home birthing is an extremely safe option for both mother and baby.  Scientists at the University of Oxford in England found that the risk of injury to the newborn was less than one percent, even in births to first time mothers.1  That risk was even lower for the babies of women who had previously given birth. In fact, second births had statistically the same risk no matter whether they took place at home, in a midwife-led facility, or in a hospital setting overseen by a doctor.

In this birthplace study, the researchers analyzed information on nearly 65,000 births in England in those three different settings.  The participants had no difficulties during their pregnancies and had no risk factors as they went into labor.  The overall rate of complications was 5.3 per 1,000 births in a hospital versus 9.3 per 1,000 births at home.  The births overseen by a midwife in a facility had the same rates as hospital births.  Upon having a second baby, there was absolutely no difference in risk for children born in a hospital, in a mid-wife led unit, or at home.

Interestingly, nearly half of the women -- approximately 45 percent -- who initiated a home birth ended up at a hospital.  Rarely was this because the baby was in distress, however.  The majority of the transfers took place because of a slow progression of labor or a change of heart on the woman's part in wanting an epidural for some pain relief.  Maybe those women realized the second time around that they could make it through their deliveries at home, since the rate of transferring to a hospital for a second-time mother dropped to 12 percent.

In the United Kingdom, as in much of the Western world, the vast majority of births take place in hospital settings.  Approximately 90 percent of all babies in England are born in hospitals and only three percent of babies are born at home.  Which is unfortunate, because the study also found that when a midwife is delivering the baby -- whether at home or in a midwife-run facility -- chances are much greater that the birth will be natural and not involve suction or forceps.  And obviously no drugs are used, as is so common when an obstetrician is leading the way.  In addition, the emergency Caesarean rate for women giving birth in hospitals was determined to be 11 percent, while it was 4.4 percent when a midwife was delivering in a medical unit, and only 2.8 percent for home births.

Now, once you have undergone an emergency C-section, it is very difficult to find a doctor who would okay a birth plan for a home birth for subsequent babies.  The medical establishment brands you high risk automatically.  Obviously, the safety of the baby comes first, and if it is truly medically necessary, by all means submit to the C-section.  However, if it is a matter of slow progression, you might want to consider all options.

Another thing to keep in mind is trying to take the best care of yourself that you can both before and during pregnancy to keep your risk factors low and enable yourself to have a natural birth in any setting you choose.  Eating a well-balanced diet is never more important.  Keep exercise low impact but frequent.  And supplement with "the right" prenatal vitamins and nutrients that will be beneficial to both your body and the growing fetus inside you.  Some of the most important to include are vitamin D, vitamin A, folic acid, and calcium.  If you normally supplement with herbs, discontinue unless you know for sure they are safe during pregnancy.  If you are generally healthy, just a few minor adjustments should make pregnancy and delivery smooth, easy, and safe no matter where you choose to have your child.

 

1 Brocklehurst, P. "Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study." BMJ. 24 November 2011.  BMJ Publishing Group Ltd. 8 December 2011. <http://www.bmj.com/content/343/bmj.d7400?tab=full>.

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Comments

  •  
    Submitted by Brian DeMoss on
    December 29, 2011 - 11:55am

    Good post. Just enough meat here to get my attention and cause me to share it with others. Thanks. I know a few people who would benefit from the information you have here about Home Births.

  •  
    Submitted by safe birth on
    January 20, 2012 - 6:59am

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