Monday, 17 November 2008 20:10
“Outcomes of planned home births with certified professional midwives: large prospective study in North America.” Kenneth C Johnson, senior epidemiologist, Betty-Anne Daviss, project manager. BMJ 2005;330:1416 (18 June).
Published online at http://bmj.bmjjournals.com/cgi/content/full/330/7505/1416?ehom
The largest prospective study of planned home birth with a direct-entry midwife shows that homebirth is as safe as hospital birth for low risk women, yet carries a much lower rate of medical interventions, including Cesarean section.
This landmark study is reported in the latest issue of British Medical Journal, June 2005. Planning a home birth attended by a Certified Professional Midwife (CPM) offers as safe an outcome for low-risk mothers and babies as does hospital birth. This study is the largest yet of its kind. The researchers used prospective data on more than 5400 planned home births in North America attended by Certified Professional Midwives during the year 2000.
Canadian researchers Kenneth Johnson and Betty-Anne Daviss studied over 5,400 low-risk pregnant women planning to birth at home in the United States and Canada in 2000. The researchers analyzed outcomes and medical interventions for planned home births, including transports to hospital care, and compared these results to the outcomes of 3,360,868 low risk hospital births. According to the British Medical Journal press release, they found:
88% of the women birthed at home, with 12% transferring to hospital.
Planned home birth carried a rate of 1.7 infant deaths per 1,000 births, a rate "consistent with most North American studies of intended births out of hospital and low risk hospital births."
There were no maternal deaths.
Medical intervention rates of planned home births were dramatically lower than of planned hospital births, including: episiotomy rate of 2.1% (33.0% in hospital), cesarean section rate of 3.7% (19.0% in hospital), forceps rate of 1.0% (2.2% in hospital), induction rate of 9.6% (21% in hospital), and electronic fetal monitoring rate of 9.6% (84.3% in hospital).
97% of over 500 participants who were randomly contacted to validate birth outcomes reported that they were extremely or very satisfied with the care they received.