Less than one percent of babies in the U.S. are born at home. But after years of decline, home births are on the rise. Between 2004 and 2008, the rate of home births increased by 20 percent, according to a study published online May 20 in the journal Birth. Why? Maybe alienation with hospital care—where around a third of babies were delivered by Cesarean section in 2007—has some women wanting more control over what they consider a normal, natural experience. They want, in a sense, to stay home to stay safe. But are they right? Is home birth safe?
While the question is a polarizing one, at least in this country, several professional organizations say it can be for low-risk pregnancies if necessary precautions are taken. That includes the World Health Organization, the American Public Health Association, the National Perinatal Association, and the American College of Nurse-Midwives.
For support, one organization points to, among other things, a study published in 2005 in the British Medical Journal that found that “Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.”
Some also cite the experience of European countries. For example, in the Netherlands, where there are established systems in place to support home birth, about 30 percent of babies are born at home. Yet the Netherlands still has lower maternal and neonatal mortality rates than the U.S., according to UNICEF.
The American College of Obstetricians and Gynecologists, on the other hand, doesn’t support planned home births, regardless of risk. And a controversial study in the American Journal of Obstetrics and Gynecology published last year concluded that there was a significant increased risk of neonatal death among home births.
Bottom line: Home birth might be a safe alternative for low-risk women, according to some but not all professional organizations. If you’re considering one, it’s important to get care from a skilled and experienced practitioner. That could be an M.D., but is more likely to be a certified midwife. Make sure, too, that you have easy access to more advanced care if needed. That means knowing in advance when you would go to a hospital, where you would go, and how you would get there.
For more on non-invasive measures and childbirth, see our article “Back to basics for safer childbirth.”
United States Home Births Increase 20 Percent from 2004 to 2008 [BIRTH]
—Joan Combellick, CNM., MPH