|
Safety and Home Birth
Any environment, whether home, hospital or birthing center, presents a distinct set of risk factors for birth. No care provider or birth setting can guarantee a perfect outcome. We believe each woman has the right to an informed choice of the environment which she perceives as safest for her and her baby. Many women do not appreciate mainstream obstetrics’ approach to pregnancy as a problem waiting to happen. For such women, home birth is a logical choice. We endeavor to create an environment which supports women in opening to their own instinctive process rather than imposing artificial interventions or attempting to make labor conform to a specific pattern. When allowed to follow its natural course, pregnancy usually results in the birth of a healthy baby and mother. |
|
Do you know the benefits associated with home birth?
- Statistics show that home birth is as safe, or safer than, hospital birth for low-risk women with adequate prenatal care and a qualified attendant.
- Labor is allowed to progress normally, without interference and unnecessary interventions (and their corresponding potential negative side-effects).
- Studies show that the risk of infection is reduced for both the mother and the baby.
- During labor the mother is encouraged to eat, drink, walk, change positions, make noise, shower, bathe, etc. She may invite supportive family members or friends to be present.
- The mother enjoys receiving care during labor from familiar faces. The trusting relationship developed during prenatal care increases a mother’s sense of safety and confidence in her body’s ability to give birth.
- Bonding is enhanced and includes everyone who has contact with the baby including neighbors and relatives. Breast feeding is facilitated by the baby remaining with the mother.
- Cesarean Section and forceps deliveries are unavailable - transportation to the hospital is necessary if these interventions are required. However, rates of both, as well as episiotomy, are very low.
Do you know the disadvantages, or risks, associated with home birth?
- Clients must assume a greater level of responsibility for their own health: physical, mental and spiritual. This requires active ongoing participation in shared decision-making in all aspects of their care, and a willingness to accept the consequences of those choices and decisions.
- Since the hospital is the currently socially acceptable location for birth, choosing otherwise may result in negative judgments and lack of support.
- Personal arrangements must be made for postpartum care, such as meals, housekeeping, child care etc. The cost of a home birth may not be covered by the client's insurance. Clients provide their own birth supplies.
- Analgesics are not readily available with a home birth.
- Cesarean Sections, forceps/vacuum-assisted deliveries and a neonatologist are not available at home;
- transport is necessary for these and other medical interventions.
- In the event of a rare emergency, it may not be possible to transport the mother or baby to a hospital in time to benefit from hospital resources.
What are the safety statistics?
The majority of scientific evidence shows that home birth is a safe alternative to hospital birth for low-risk women, provided the birth is attended by a skilled midwife. A 2009 study of 12,972 births in Canada divided into three groups (planned home births with midwives, planned hospital births with the same midwives, and planned hospital births with physicians) showed that planned home birth attended by a midwife was associated with very low and comparable rates of perinatal death (0.35 per 1000 births) and reduced rates of obstetric interventions and other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician. [Janssen P,et al. Outcomes of planned home births with registered midwife versus planned hospital birth with midwife or physician. CMAJ. 2009 Sept. 15;181(6-7):377-83.] Another study of home birth in North America showed lower rates of medical interventions but similar mortality rates to that of low risk hospital birth in the United States. [Johnson KC, et al. Outcomes of planned home births with certified professional midwives: large prospective study in North America. BMJ. 2005 Jun 18;330(7505):1416.] Other studies show intrapartum/neonatal mortality rates ranging up to about 2.0 per 1000 births, which is consistent with typical mortality rates of low-risk women birthing in a hospital setting.
Clients are encouraged to review the bibliography of study abstracts related to midwifery care and out-of-hospital birth provided.
The range of natural variation is extremely wide. Occasionally, a critical situation arises during pregnancy or labor which necessitates specialized care that cannot be provided in a home setting. In such cases, a previously established medical system is relied upon for appropriate care. It is important to give consideration to the distance and estimated transport time between your planned birth site and the nearest hospital in the event transfer of care is needed.
The majority of scientific evidence shows that home birth is a safe alternative to hospital birth for low-risk women, provided the birth is attended by a skilled midwife. A 2009 study of 12,972 births in Canada divided into three groups (planned home births with midwives, planned hospital births with the same midwives, and planned hospital births with physicians) showed that planned home birth attended by a midwife was associated with very low and comparable rates of perinatal death (0.35 per 1000 births) and reduced rates of obstetric interventions and other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician. [Janssen P,et al. Outcomes of planned home births with registered midwife versus planned hospital birth with midwife or physician. CMAJ. 2009 Sept. 15;181(6-7):377-83.] Another study of home birth in North America showed lower rates of medical interventions but similar mortality rates to that of low risk hospital birth in the United States. [Johnson KC, et al. Outcomes of planned home births with certified professional midwives: large prospective study in North America. BMJ. 2005 Jun 18;330(7505):1416.] Other studies show intrapartum/neonatal mortality rates ranging up to about 2.0 per 1000 births, which is consistent with typical mortality rates of low-risk women birthing in a hospital setting.
Clients are encouraged to review the bibliography of study abstracts related to midwifery care and out-of-hospital birth provided.
The range of natural variation is extremely wide. Occasionally, a critical situation arises during pregnancy or labor which necessitates specialized care that cannot be provided in a home setting. In such cases, a previously established medical system is relied upon for appropriate care. It is important to give consideration to the distance and estimated transport time between your planned birth site and the nearest hospital in the event transfer of care is needed.