NEW YORK (Reuters Health) Jul 28 - In terms of perinatal morbidity and mortality, a planned home birth is as safe as a planned hospital birth, provided that a well-trained midwife is available, a good transportation and referral system is in place, and the mother has a low risk of developing any complications, new research shows.
"Low-risk women should be encouraged to plan their birth at the place of their preference, provided the maternity care system is well equipped to underpin women's choice," Dr. A. de Jonge, from TNO Quality of Life, Leiden, the Netherlands, and co-researchers emphasize in the August issue of BJOG: An International Journal of Obstetrics and Gynaecology.
Data regarding the safety of home births in low-risk women are lacking, due in part to the fact that studies with very large sample sizes are needed to assess relatively rare adverse outcomes. Moreover, randomized trials comparing home and hospital births have not been done because women usually want to choose their place of birth, the authors explain.
The present study, an analysis of 529,688 low-risk planned births, was conducted in the Netherlands, the only country in the west with a large enough data set. The group included 321,307 women who wanted to give birth at home, 163,261 who planned to give birth in the hospital, and 45,120 with an unknown intended place of birth.
All of the outcomes studied occurred with comparable frequency in the planned home and hospital birth groups. These included intrapartum death (0.03% vs. 0.04%), intrapartum and neonatal death within 24 hours of birth (0.05% vs. 0.05%), intrapartum and neonatal death within 7 days (0.06% vs. 0.07%), and neonatal admission to an intensive care unit (0.17% vs. 0.20%).
"As far as we know, this is the largest study into the safety of home births," the authors note. The findings, they conclude, indicate that with proper services in place, home births are just as safe as hospital births for low-risk women.