USA Today Examines Arguments On Safety, Risks Of Home Births

Main Category: Pregnancy / Obstetrics
Also Included In: Nursing / Midwifery
Article Date: 16 Sep 2009 - 3:00 PDT

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USA Today on Monday examined the debate over the safety of home births attended by certified midwives. The percentage of home births dropped dramatically in the U.S. during the first half of the 20th century. Currently, less than 1% of births in the U.S. take place at home, compared with nearly 30% in the Netherlands.

Canadian and Dutch studies have found that home births attended by qualified midwives appear to be as safe as hospital births for low-risk women. However, many groups still oppose the practice because of safety concerns. The American College of Obstetricians and Gynecologists has campaigned against home births, and the American Medical Association's House of Delegates in 2008 passed a resolution stating that "the safest setting for labor, delivery and the immediate postpartum period is in the hospital, or a birthing center within a hospital complex."

Erin Tracy, an ob-gyn at Massachusetts General Hospital and ACOG's delegate to AMA, said that the studies in Canada and the Netherlands were not large enough to adequately assess potential problems during home births. Tracy said problems during childbirth are infrequent, regardless of where the birth takes place, and that only studies with "really large numbers" could reveal whether home birth is as safe as hospital birth. Although the majority of patients "might get away with it," low-risk pregnancies develop into high-risk situations in minutes, Tracy added. For example, the infant's shoulder could become stuck in the birth canal, or heavy bleeding could necessitate a blood transfusion for the woman.

Alice Bailes, a certified nurse-midwife, said that those in her profession have "wonderful relationships with hospital-based practices," including ob-gyns and midwife practices. She added, "These relationships ... are important for peace of mind for us and our clients and for safety." Bailes said women rarely need to be transferred from home to the hospital -- about one in nine end up being moved -- because nurse-midwives refer higher-risk patients to hospital-based practices before they go into labor (Rubin, USA Today, 9/14).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

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