Study: Home Birth Ten Times Riskier Than Hospital BirthJoslyn Gray
It’s not my thing, but I do understand the appeal of home birth, and I get why my fellow Babble writers Monica and Serge Bielanko are excited to have their third baby at home with a midwife. And chances are, they’ll have a safe and happy home birth.
As for me, I find hospitals and medical technology reassuring as opposed to invasive. Also, honestly, birth is a very, very messy process, and I have no interest in having that kind of Dirty Jobs-level mess happen in my home. But mostly, for me, it’s all about having that medical team there. Right there.
My first babies were twins, delivered preterm via emergency Cesarean section and promptly whisked away to the Neonatal Intensive Care Unit. They struggled to breathe. Their heart rates dropped. After that, high-risk or not, nothing less than a Level III NICU would do.
My third baby, a singleton, was born full-term in a midwife-assisted VBAC (vaginal birth after cesarean). It wasn’t a high-risk pregnancy, but I still chose a midwifery with a birthing center in the hospital. And although my next pregnancy was followed by a midwife, my son ended up being born a little early, with another emergency C-section because of pre-eclampsia.
I’ve had incredibly positive experiences with three hospital births, and I owe my children’s lives and my own life to the skilled care we received from top-notch doctors, midwives, nurses, and anesthesiologists. I know not everyone has had such positive hospital experiences, and I can understand the strong urge to keep things quieter and more private, at home.
However, home births are riskier than hospital births, a new study confirms. Researchers reviewed U.S. birth records and found that babies born at home, even with a midwife present, were ten times more likely to lack a pulse and be unresponsive at five minutes old.
It sounds dire, but the chances of that happening are still really, really low. The study, published in the American Journal of Obstetrics and Gynecology, looked at data from 13 million birth certificates from 2007 to 2010, the vast majority of which occurred in hospitals. The study only looked at singleton births that occurred at 37 weeks gestation or later, in which the baby was at least five and a half pounds at birth.
Four categories were examined: hospital birth with a medical doctor, hospital birth with a midwife, free-standing birthing center with a midwife, and home birth with a midwife.
For every 1,000 babies born, the following number lacked a pulse and weren’t breathing five minutes after birth:
- Hospital birth, midwife attending: 0.09
- Hospital birth, M.D. attending: 0.16
- Free-standing birthing center, midwife attending: 0.55
- Home birth, midwife attending: 1.6
The study also found that babies born at home were four times as likely to have seizures or other serious neurologic dysfunction as babies born in hospitals.
The study authors emphasized that mothers who are transferred from home or a birthing center to a hospital counted as hospital births, no matter what the outcome.
“Obviously, correction of this factor would further negatively impact the relative risk of all adverse outcomes for births out of the hospital,” wrote lead author Amos Grunebaum, M.D.
The study isn’t an indictment of parents who choose home births; rather, the study authors urge medical professionals to examine the reasons those parents don’t want a hospital birth.
“Physicians also have the professional responsibility to address the root cause of patients’ motivations for out-of-hospital delivery,through continuous efforts to address patient concerns about interventions,” wrote Dr. Grunebaum, “and to improve compassionate and safe care of pregnant, fetal, and neonatal patients in the hospital setting.”
Everything about birth and parenting is so incredibly personal. There are risks and benefits to everything we do, every day. We all make the best decisions we can make–what works for us as parents, what works for our children, what works for our family as a whole unit. For many families, home birth makes sense, as Serge Bielanko beautifully articulates in his post, Don’t Be Afraid, It’s Just a Home Birth. They’ve done their research.
I did my research too, and I chose hospital birth. Because what Serge finds reassuring: “this is how people have been having babies since the beginning of time,” is exactly what I find distressing. Because the other side of that coin is that women and babies have been dying in childbirth since the beginning of time. If there’s a way to reduce that risk for myself or my children–no matter how small that risk may be–I’ll do it.
Have you had a home birth, or would you consider it?