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A landmark study, published recently in British Medical Journal, has found that natural birth at home, under the care of certified practicing midwives (CPMs, also called direct-entry or apprentice-trained midwives), is safe for healthy mothers and babies, with much lower rates of medical interventions.
The study tracked over 5000 mothers who planned to give birth at home under CPM care in the U.S. and Canada in 2000, and compared their outcomes with low-risk mothers giving birth in hospital. The authors looked at the numbers of babies dying around the time of birth, and also at the use of medical interventions.
The Results
Around 12 percent of mothers required transfer to hospital after the start of labour, around half for failure to progress, pain relief and exhaustion. Most transfers happened before birth, and only 3.4 percent of women required an emergency transfer at any stage.
Rates of intervention, compared to low-risk women giving birth in hospital were
*Electronic fetal monitoring 9.6 percent compared to 84 percent
*Epidural 4.7 percent compared with 63 percent
*Induction of labour 9.6 percent compared with 21 percent
*Forceps or vacuum delivery 1.6 percent compared with 7.4 percent
*Episiotomy 2.1 percent compared with 33 percent
*Cesarean 3.7 percentcompared with 19 percent
The number of babies dying was 2/1000, which is comparable to most other studies of homebirth, and to low-risk mothers giving birth in hospital.
Over 97 percent of mothers reported that they were extremely or very satisfied with the birth, and 89.7 percent were fully breastfeeding at six weeks.
British Medical Journal June 18, 2005
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