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Home births are becoming more popular in the U.S., leading to questions about safety. A large international study recently found planned home births by low-risk women posed no more risk to babies than hospital births. However, this was true only for home births occurring within a system of standards and regulations.
Researchers used data from 21 studies published since 1990 comparing home and hospital birth outcomes in Sweden, New Zealand, England, Netherlands, Japan, Australia, Canada, and the U.S. They looked at the risk of neonatal death during birth or within the first four weeks and found no statistical difference between approximately 500,000 planned home births and 500,000 hospital births.
In the U.S., only 33 states license midwives to legally attend home births, leaving the practice marginalized and risky in the rest of the country. When midwives are integrated into the healthcare system, research shows, there are lower rates of c-sections, interventions, and adverse neonatal outcomes – regardless of where the births take place.
Meanwhile, in states where midwives are prohibited from attending home births, they are neither regulated nor supported by local hospitals. The birth outcomes can be tragic, as was the case recently for a couple in Nebraska.
Studies have found that women undergo fewer unnecessary interventions when they deliver at home. There is also evidence that women are less likely to experience postpartum hemorrhage during a planned home birth.
According to Dr. Kate McLean of the University of Washington, "maternal outcomes are likely better at home because the possibility of unnecessary interventions is removed, although those interventions can still be obtained efficiently through transfer to a hospital."
This is significant because the U.S. has seen a steady increase in pregnancy-related deaths in hospitals over the last three decades. Researchers estimate that 50% of maternal deaths are preventable. Racial and economic factors also play a role in maternal mortality – black women are three to four times more likely to die from childbirth complications than white women.
If you're considering giving birth at home, be sure to choose a licensed and regulated midwife. See our article on planned home birth to learn more about the risks and benefits.
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