Is homebirth safe?
Safety has been held up as the reason why all women should give birth in the hospital. This is despite the fact that no data support the contention that homebirth holds any excess risk provided:
- the mother is low risk
- the homebirth is planned
- she has a trained, experienced birth attendant
- there is a modern hospital within a reasonable distance
In particular, an analysis of six homebirth studies totaling 24,100 women came to exactly this conclusion (10). Homebirth studies have not only failed to show more than the expected number of stillbirths and newborn deaths (perinatal mortality), but they have not found excesses of other, more common adverse outcomes, such as low Apgar scores (a measure of the baby’s condition at birth), the need for resuscitation, or admission to newborn intensive care units (1, 4-5, 12, 15-16).
As further evidence, researchers in Holland, a country where homebirth never disappeared, compared the perinatal mortality rate in the early 1980s for various cities and regions with the percentage of homebirths and found no correlation, although homebirth rates ranged from very few, to fifty percent of the births (13). In the U.S., an analysis of California data for 1989 and 1990 calculated that low-risk women opting for birth outside of a hospital had a slightly lower perinatal death rate --- including births moved into the hospital for complications, compared with low-risk women managed by obstetricians in hospitals (11).
