Both of my children were born at home. Obviously, I have a bias. I believe that planned home birth is safe. I believe pre and post natal care with midwives is exceptional. I believe women have the right and ability to give birth naturally.
In the largest ever conducted home birth study, midwives reported that of 16,924 planned home births, 89.1% proceeded as planned successfully at home.
Citizens for Midwifery reports:
New research published in the Journal of Midwifery and Women’s Health examines outcomes for nearly 17,000 women who went in to labor intending to deliver at home between 2004 and 2009 in the United States. The data were collected through the MANA Statistics Project (Cheyney et al., 2014; and the companion piece, also Cheyney et al., 2014); it is the largest study of planned, midwife-led home births in the U.S. to date….
The data in this study were collected prospectively; that is, midwives logged in each client at the initiation of her care, and continued to log in data concerning that client throughout her pregnancy, birth, and up to 6 weeks postpartum. This method of data collection reduces the possibility that midwives could choose to enter only the cases with positive outcomes, as the outcomes of care are not known when the client is logged. Importantly, most studies of birth outcomes to date have relied on birth certificate data, which, for the most part, do not collect data by intended place of birth. This is extremely important because unplanned home births and unassisted home births carry different risks than planned home births with skilled attendants. In addition, women who begin labor at home, but then transfer to the hospital during labor, are listed as hospital deliveries when their outcomes actually belong in the home birth sample.
The findings are truly supportive that home birth is safe for women and babies in the US.
* High rate of completed home birth / low rate of transfer*
89.1% of babies were born at home. 10.9% of women transferred to a hospital, either during labor or postpartum. By far, the most common reason for transfer to the hospital was “failure to progress.” Only a very small proportion of the transfers occurred for urgent reasons, such as fetal distress.
* High rate of vaginal birth / low cesarean section rate*
93.6% of women in the sample gave birth vaginally. Of those women who transferred to the hospital, 53.2% still had vaginal births. The overall cesarean section rate for this sample was 5.2%.
* High rate of completed vaginal birth after cesarean (VBAC)*
87.0% of women attempting a VBAC gave birth vaginally and 94% of those were completed at home.
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* Low rate of obstetrical intervention*
Under 5% of women in this sample required the use of oxytocin augmentation or epidural anesthesia.
* Low rate of low APGAR scores*
1.5% of babies had 5-minutes APGAR scores below 7 and 0.6% had scores below 4.
*Extremely high rate of breastfeeding at 6 weeks*
97.7% of babies were breastfeeding (at least partially), and 86.0% were breastfeeding exclusively at 6 weeks postpartum in this sample. This is an extraordinarily high rate of breastfeeding initiation and continuation, and it is a very important finding to consider in the overall evaluation of the risks and benefits of home birth. Not being breastfed is associated with considerable health consequences to newborns (Stuebe, 2009). These data suggest that home birth is associated with the extremely significant protective factor of maintained breastfeeding.
The reason planned home births are so successful is because of superior prenatal care. An average prenatal visit with a midwife lasts 45 minutes versus 10 minutes with a medical doctor. Midwives and patients thoroughly discuss all aspects of pregnancy and labor, as well as post partum life. Prospective mothers are informed to the risks and most often self-select or are referred to an OB-GYN if their pregnancy offers a high risk. Of course some midwives take great risks then others, such as taking on patients late in term or delivering breech babies, but overall the safety record is so high for home births because midwives are thorough and careful.
As Citizens for Midwifery explains about the Midwives Alliance of North America (MANA) study:
The MANA Stats data findings clearly illustrate that planned home birth with skilled midwives is safe for healthy women with low-risk pregnancies, and additionally, can confer many positive benefits in this population.
The data are less clear with regard to women with higher risk pregnancies, especially those with babies in breech position and those attempting a VBAC. Of 222 babies presenting in breech position, 5 died either during labor or the neonatal period. Of the 1052 babies born to women attempting a VBAC, 5 died. Taken alone, these data do not have the power to inform women’s choices as many questions remain unaddressed. These intrapartum and neonatal death rate data presented here raise more questions than they answer with regard to women with higher risk pregnancies, specifically those with babies in a breech position and those attempting a VBAC.
Via: The Raw Food World