According to an oral presentation presented at 32nd annual meeting of the Society for Maternal-Fetal Medicine, more women are choosing home births today than ever before, but information regarding the safety of home births is non-conclusive. Study authors reviewed more than two million live births to create a home birth study group of around 12,000. While home births result in significantly lower risk of obstetric interventions, low APGAR score and seizure risks were higher.
Researchers collected data on 2.08 million live births in 2008. While the majority of women chose hospital births (99.42%), a growing population chose home births (0.58% or 12,039 women). Of the planned home births, 21% were planned by first-time mothers and the remaining 79% of women had already given birth at least once in the past. The majority of women planning home births are between 20 and 34 years of age, which is also the case in planned hospital births. Caucasian, married women with a high-school diploma or college education with uneventful pregnancies at full-term were most likely to give birth at home – reducing overall risks of all kinds.
Based upon the births reviewed by study authors, home births increased the risk of 5-minute APGAR scores less than 4, 5-minute APGAR scores less than 7 and seizures. Hospital births showed an increased risk of admission to neonatal intensive care units and ventilator support. On the flip side, hospital births increased the risk of operative vaginal birth, labor induction, assistance during labor and the use of antibiotics during labor significantly, compared to home births.
The American Congress of Obstetricians and Gynecologists (ACOG) support a woman’s right to choose the birth setting and birth attendant, but ACOG suggests women choose certified midwives (American Midwifery Certification Board). This support is echoed by the American College of Nurse-Midwives, but there are clearly increased risks to infants born in a home setting.
Conclusion: Based on this review of birth records, infants born in a home setting are at increased risk of 5-minute APGAR scores below 4 and 7 and seizures. Women, on the other hand, are at decreased risk of medical intervention of any kind during birth.
Source: Yvonne W. Cheng, MD, Ph.D., Jonathan M. Snowden, Ph.D., Tekoa L. King, CNM, MPH, Aaron B. Caughey, MD, Ph.D. Selected perinatal outcomes associated with planned home births in the United States. American Journal of Obstetrics & Gynecology. Volume 209, Issue 4 , Pages 325.e1-325.e8, October 2013Doi:10.1016/j.ajog.2013.06.022.
