Los Angeles - Great controversy surrounds the issue of home births. American doctors are generally opposed to the practice, but many women say they would prefer to give birth at home. Studies on the safety of home births have been mixed.
However, a study published recently - one of the stronger attempts to clarify the issue - has found that planned home births attended by registered midwives have similar rates of fetal death and adverse outcomes as compared with hospital births. The study followed 2 889 women in British Columbia who had planned home births between 2000 and 2004. They were compared with 4 752 women who gave birth in a hospital.
The fetal death rate was less than one per 1 000 births in both groups, and Apgar scores, a rating of a newborn's health, were similar.
The only difference between the groups is babies born at home are more likely to be hospitalised, usually because of infant jaundice. Jaundice in hospital-born infants is usually detected and treated before the infant is discharged. The study is published in the Canadian Medical Association Journal.
The study "should add confidence to the safety of home birth in a context such as ours in which registered midwives have a baccalaureate degree or equivalent and are an integral part of the health care system," the authors, from the University of British Columbia, wrote. "Our findings do not extend to settings where midwives do not have extensive academic and clinical training."
An editorial accompanying the study notes that the good outcomes found by the researchers may be due in part by self-selection; that is, women who choose home birth endorse the practice and are motivated to achieve success. More studies should be conducted before home births become standard for large populations of women, the editorial adds. "The debate about the safety of home births cannot be driven by ideology. The call for better evidence remains." - Los Angeles Times