The Safety of Homebirth

A growing body of research demonstrates that planned home birth with appropriately trained midwives can be a safe option for low-risk women.

The safety of home birth depends on appropriate client selection, informed decision-making, skilled providers, emergency preparedness, and access to consultation and transfer when necessary.

There is evidence-informed maternity care and research to support families to discuss their individual circumstances with qualified healthcare providers when considering their birth options.

Studies have shown that planned home birth is associated with:

• Lower cesarean rates

• Lower rates of induction

• Lower rates of instrumental delivery

• Reduced maternal morbidity

• High levels of maternal satisfaction

• Comparable outcomes for carefully screened low-risk pregnancies when integrated systems of care are available

It is in the Evidence

Cheyney et al. (MANA Statistics Project)

Cheyney M, Bovbjerg M, Everson C, Gordon W, Hannibal D, Vedam S.Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004–2009. Journal of Midwifery & Women's Health, 2014. This is one of the largest U.S. datasets of planned home births.​

 

Hutton et al. (Ontario Home Birth Study)

Hutton EK, Reitsma AH, Kaufman K.Outcomes Associated with Planned Home and Planned Hospital Births in Low-Risk Women Attended by Midwives in Ontario, Canada, 2003–2006. Birth, 2009. Compared low-risk planned home births with planned hospital births attended by midwives.​

 

Hutton et al. (Planned Place of Birth Study)

Hutton EK, Cappelletti A, Reitsma AH, et al.Outcomes Associated with Planned Place of Birth Among Women With Low-Risk Pregnancies. CMAJ, 2016. Found no significant difference in serious adverse neonatal outcomes between planned home and planned hospital birth in the Ontario cohort, while intervention rates were lower in the planned home birth group.​

 

Reitsma et al. (Systematic Review & Meta-analysis)

Reitsma A, Simioni J, Brunton G, Kaufman K, Hutton EK.Perinatal or Neonatal Mortality Among Women Who Intend at the Onset of Labour to Give Birth at Home Compared to Women of Low Obstetrical Risk Who Intend to Give Birth in Hospital: A Systematic Review and Meta-Analyses. EClinicalMedicine, 2019.​

 

National Academies Reports

The most useful National Academies publication for legislators is:

National Academies of Sciences, Engineering, and MedicineBirth Settings in America: Outcomes, Quality, Access, and Choice (2020). Reviews evidence regarding hospital birth, birth centers, and home birth, and discusses policy implications.

Birth Center Outcomes Studies

American Association of Birth Centers (AABC) Strong Start Evaluation

One of the most frequently cited birth center outcome datasets in the United States. Examines maternal and neonatal outcomes among women receiving care in freestanding birth centers.