Home births have been linked to low rates of caesarean section, postpartum hemorrhage, and third-degree perineal tears in a new study.
The research, published in the Medical Journal of Australia, a publication of the Australian Medical Association, also showed that low rates of stillbirth and early neonatal death were recorded.
The home births analyzed in the study, led by Dr Christine Catling-Paull, Lecturer in Midwifery and Prof Caroline Homer, Professor of Midwifery, at the University of Technology Sydney, were performed within the public health system in Australia.
The authors emphasized that it is not possible to draw any strong conclusions regarding the safety of home births in this study, because the sample size was not large enough.
The investigators gathered and examined data from 9 publicly funded home birth programs between 2005 and 2010 in order to look at maternal and neonatal outcomes.
Results showed that 84% (1,521) of the 1,807 women who planned to give birth at home at the onset of labor were able to do so.
Seventeen percent (315) of the subjects were transferred to hospital during labor or within one week of giving birth, according to the authors.
The rate of stillbirth and early neonatal death was 3.3 per 1000 births, and when the results did not include deaths due to expected fetal anomalies, the rate was 1.7 per 1000. The rate of vaginal birth was 90%.
The scientists said:
“Overall, 315 women and/or their babies were transferred to hospital during labour or within one week of giving birth … Fifteen babies (1%) were born before the arrival of the midwife at the woman’s home.”
Almost all of the women analyzed started off breastfeeding, and at 6 weeks, 69% were still breastfeeding.
The outcomes in the report might be a result of the strict eligibility standards for females to access a publicly funded home birth, the experts pointed out.
The majority of the women eligible have no surgical, medical, or obstetric risk factors, have a singleton pregnancy, are within 37-42 weeks’ gestation, and have normal pregnancies.
This research provides evidence about home birth as a possibility for women at low obstetric risk. However, further studies are “warranted into the safety and costs of alternative places of birth within Australia,” the authors said.
Professor Marc Keirse, from the Department of Obstetrics and Gynecology at Flinders University in Adelaide, wrote in an editorial:
“Many may wonder why there should be publicly funded home birth programs when data suggest that only 0.5 per cent of pregnant women in Australia opt for a home birth.
It is a woman’s prerogative and her fundamental human right to determine her reproductive behavior, and this includes how and where to give birth. The issue is how to accommodate the autonomy of pregnant women in as safe a manner as possible for both mother and baby.”
A previous study published in the American Journal of Obstetrics & Gynecology showed that having an experience similar to home birth in the hospital proves to be more financially feasible, safer, and more satisfying than an actual at home birth.
Written by Sarah Glynn