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Archive for May, 2012

Is home birth safe?

Most doctors in the US will say no, absolutely not. But is that really true? Here are a couple studies so that you may decide for yourself.

1. 2009 study published in the Canadian Medical Association Journal (CMAJ)
Conclusion: “Planned homebirth attended by a registered midwife was associated with very low and comparable rates of perinatal death and reduced rates of obstetric intervention and other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician.”
 Details: This is a very good study because it looked at only women who were low-risk; even the women who gave birth in the hospital would have qualified for a home birth if they had desired. Therefore, the study is not biased in favor of homebirth, but is as fair as humanly possible. For a planned home birth, rates of perinatal (baby) death per 1000 births was 0.35. For the planned hospital births with a midwife, rates of perinatal death per 1000 births was 0.57. For planned hospital births with a physician, rates of perinatal death were 0.64. Notably, the study finds that women who had planned home births were significantly less likely to have bad maternal (mother) outcomes, such as severe tearing or hemorrhage.

2. 2005 study published in the British Medical Journal
Conclusion: “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.”
Details: This study looked at all of the planned home births in 2000, attended by Certified Professional Midwives in the US and Canada, in locations where home birth is not integrated into the healthcare system or well-accepted by most medical providers in the area.

3. The Maternal Mortality Rate in the U.S. is atrocious, for how medically advanced we think we are. 
Instead of having fewer mothers die in childbirth now as opposed to 20 years ago, the US has actually seen an increase in maternal deaths since 1990. This means that a woman in her twenties is more likely to die in childbirth than her mother was. As an industrialized country, we fall dismally behind countries such as Canada, Japan, and the Netherlands, all of which have midwives attending the majority of births. We rank 39, which means that 38 countries have better maternity survival rates than we do…and most of them are substantially better.

So what have we done wrong? Why are women more likely to die in childbirth than they were only 20 years ago? Could it be  due to the skyrocketing unnecessary medical interventions such as induction and cesareans? Could it be that maybe, with all our medical advances in case of emergency, we’re so on edge that doctors actually create the very circumstances they were trying to avoid? Could it be that most births are not medical emergencies, and that most women will give birth safely to healthy babies if left to their own timing, with a midwife who will offer support and appropriate medical care throughout this phenomenal life change?

Maybe. Maybe we’ve had it all wrong.

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