Planned home births pose little risk with well-integrated midwifery, according to US research

on 12 October 2021

Researchers at the University of British Columbia (UBC) have conducted a study into planned home births where it was found they were just as safe with a licensed midwife present as a planned birth in a licensed birth centre.

More than 10,000 community births in Washington, United States, were analysed by the researchers that occurred between 2015 and 2020.

40.9% of the data set planned to give birth at home, with 59.1% choosing a planned birth at a birth centre.

The results found: “Intrapartum transfers to hospital were more frequent among nulliparous individuals (30.5%; 95% CI 29.2–31.9) than multiparous individuals (4.2%; 95% CI 3.6–4.6). The caesarean delivery rate was 11.4% (95% CI 10.2–12.3) in nulliparous individuals and 0.87% (95% CI 0.7–1.1) in multiparous individuals.

The perinatal mortality rate after the onset of labor (intrapartum and neonatal deaths through 7 days) was 0.57 (95% CI 0.19–1.04) per 1,000 births. Rates for other adverse outcomes were also low. Compared with planned birth center births, planned home births had similar risks in crude and adjusted analyses.”

PhD Candidate at UBC’s School of Population and Public Health Elizabeth Nethery, who led the research, told Science Daily: “The birth setting had no association with increased risk for either parent or baby. Our findings show that when a state has systems to support the integration of community midwives into the healthcare system as Washington has done, birth centers [sic] and homes are both safe settings for birth.”

The state of Washington has one of the highest rates of community births in the US, with at least 3.5% of all births (approximately 3,000 per year) occurring with midwives at home or in a licensed birth centre.

Washington’s perinatal death rate is low at 0.57 deaths per 1,000 births.

The research team were made up of midwives, epidemiologists and obstetricians.

The research ‘Birth outcomes for planned home and licensed freestanding birth center births in Washington state’ was published in the Obstetrics and Gynaecology Journal. An overview of the study can be found here.