An important study shows that home birth
for low risk women reduces the rate of interventions without increasing adverse outcomes.
The fact is that neonatal death in otherwise
low risk women in the hospital setting is quite rare.
I wonder maternal mortality
among low risk women is just so rare that there weren't any in the data that she looked at?
This study supports previous research indicating that planned home birth with qualified care providers can be a safe alternative for
healthy lower risk women.
Planned birth at home in
low risk women without complicating conditions at the start of care in labour was associated with significant cost savings and a significant decrease in adverse perinatal outcomes avoided.
Indeed, the perinatal mortality rate for
LOW risk women cared for by Dutch midwives is HIGHER than the perinatal mortality rate for HIGH risk women cared for by Dutch obstetricians!
Simply: If hospital birth were useful, the data would support it, but all homebirth studies (1 - 20), show better outcomes of
low risk women at planned attended homebirth.
One paper in Britain claims that for a select group of
very low risk women who have had at least one successful vaginal delivery home birth is no more dangerous than hospital birth.
Maternal and perinatal outcomes
amongst low risk women giving birth in water compared to six birth positions on land.
Louise Silverton, deputy general secretary of the Royal College of Midwives, said, the study was «a major step forward in showing that home is as safe as hospital, for
low risk women giving birth when support services are in place.
Acute conditions caused by hospital birth are discussed here, to
allow low risk women to make informed choices as to place of birth.
Caroline Homer, one of the authors of the study, and Hannah Dahlen, a spokesperson for the Australian College of Midwives, take to the lay press to boast about the results of the study (Study of
low risk women reveals good news on the home birth front):
These two units have Midwifery Led Units in
which low risk women are cared for by midwives and in which there are options of labouring and birthing in water.
So a team of Dutch researchers decided to test
whether low risk women at the onset of labour with planned home birth have a higher rate of rare but severe outcomes (known as severe acute maternal morbidity or SAMM) than those with planned hospital births.
Original analysis of the WHOACT concluded that reducing antenatal visits of
low risk women from eight to four was not detrimental to their or their babies» health and could cut costs.
However,
low risk women tend not to need many interventions, and the vast majority of complications during pregnancy and birth come with some forewarning, so emergent transfers are extremely rare.
In the latest paper discussed in that post, Severe adverse maternal outcomes among
low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study, de Jonge concluded:
The perinatal mortality rate for
low risk women cared for by midwives is higher than the perinatal mortality rate for high risk women care for by obstetricians!
.8 / 1000 was the mortality rate for
low risk women at homebirth according to the MANA data.
There was no evidence that planned home birth among
low risk women leads to an increased risk of severe adverse maternal outcomes in a maternity care system with well trained midwives and a good referral and transportation system.