Controversial home births may be just as safe as delivering a baby in hospital for low-risk pregnancies, study finds
- Risk of newborn dying within four weeks is 7-8% higher in home births
- Scientists claim these odds are not statistically or clinically significant
- More women in ‘well-resourced countries’ are opting for home births
Controversial home births may be just as safe as delivering a baby in hospital for low-risk pregnancies, research suggests.
Scientists from McMaster University analysed data from around a million births from 14 studies to compare the dangers of different birth locations.
They found the risk of a newborn dying at the scene or within four weeks was up to eight per cent higher at home than at hospital in uncomplicated deliveries.
Although the odds are greater, the researchers claim they are neither statistically nor clinically significant.
This may be welcome news for the growing number of women in ‘well-resourced countries’ who are opting for home births, they said.
Megan Markle’s dreams of a home delivery were dashed when she was whisked to a London hospital, likely the Portland, a week overdue in May.
And supermodel Gisele Bündchen is among the host of celebrities who shunned a hospital birth, saying her home was ‘surrounded by love and where she felt safe’.
Megan Markle’s dreams of a home delivery were dashed when she was whisked to a London hospital a week overdue in May. She is pictured at The Lion King premiere in London on July 14
‘More women in well-resourced countries are choosing birth at home, but concerns have persisted about their safety,’ lead author Professor Eileen Hutton said.
‘This research clearly demonstrates the risk is no different when the birth is intended to be at home or in hospital.’
One in 50 women in England and Wales give birth at home, according to the NHS.
In the US, almost 60,000 births took place outside of hospital in 2014, Scientific American reported.
Home births are controversial due to the lack of specialised care at hand if something goes seriously wrong.
More women are opting for home births, however, many are still concerned as to its safety, the researchers wrote in The Lancet’s EClinicalMedicine journal.
Research suggests women who set out to give birth at home but end up going to hospital are less at risk of ‘obstetric interventions’, such as forceps.
However, this ‘may come at the expense of neonatal wellbeing’.
The experts looked at first-time mothers who ‘intended’ to give birth at home with a midwife present in a country with ‘well integrated health services’.
Among these women, the risk of their baby dying as a newborn or within four weeks was seven per cent higher than if they had been born in hospital.
Although the risk is greater, it was not statistically significant, the results show.
Countries that were considered to have ‘well integrated healthcare’ were England, the US, the Netherlands, Iceland, Canada and New Zealand. It is unclear how the researchers selected these nations.
A spokesperson from the parents’ charity NCT told MailOnline: ‘Integrated health systems aim to provide seamless, coordinated care for patients and their families, leading to better health outcomes.’
Gisele Bündchen is among the host of celebrities who shunned a hospital birth, saying her home was ‘where she felt safe’. The model is pictured at the The 2019 Met Gala in New York
However, the risk of infant mortality skyrocketed to more than three times in nations with ‘less integrated settings’.
The researchers defined these as Norway, Sweden, Japan and Australia.
They next looked at women who already had children and gave at home birth in ‘well-integrated settings’.
Among these women, the risk of infant mortality was eight per cent greater at home than at hospital, which was also statistically insignificant.
In ‘less integrated settings’, the risk rose to 58 per cent.
When interpreting these findings, the researchers wrote: ‘The risk of mortality was not different when birth was intended at home or in hospital.’
‘Our research provides much needed information to policy makers, care providers and women and their families when planning for birth,’ Professor Hutton said.
ADVANTAGES AND DISADVANTAGES OF A HOME BIRTH
- Women are in a familiar place where they may feel more relaxed and able to cope
- Labour is not interrupted by going to hospital
- Any children do not have to be left
- Women do not have to be separated from their partners
- Higher chance the midwife present will be known to the women
- Lower risk of intervention, such as forceps
- Women may need to be transferred to hospital if there are complications. One study found 45 out of 100 women having their first baby at home were transferred to hospital
- Epidurals are not available, however, other pain relief is
- May be safer if a woman is expecting twins or triplets
Daghni Rajasingam, consultant obstetrician and spokesperson for the Royal College of Obstetricians and Gynaecologists, told MailOnline: ‘Clinical guidelines recommend a woman who has already had a baby and who has a low risk of complications can be encouraged to give birth in any setting, such as, midwife unit, obstetric unit or home birth.
‘A woman who has not given birth previously and who has a low risk of complications will be particularly suited to plan to give birth in a midwife-led unit.
‘Giving birth in a midwife-led unit has a lower rate of use of medical interventions and the outcome for the baby is no different compared with an obstetric unit.
‘If a woman plans to give birth at home, she should be informed that there is a small increase in the risk of an adverse outcome for the baby.
‘It’s important to note giving birth is by its very nature unpredictable and a woman must have quick access to obstetric care, if an emergency develops.’
Elizabeth Duff, senior policy adviser at NCT, told MailOnline: ‘Previous research has found there’s no increased risk for women having second or subsequent babies at home if they are at low risk of complications during pregnancy, the home birth is planned and if the caregivers are qualified midwives working in an integrated health system.
‘NICE guidelines state every woman should be able to choose where they give birth, whether it’s at home, in hospital or a midwife-led unit.
‘Expectant mothers should have time and space to discuss the options available with healthcare professionals and feel empowered to make their own informed decisions about their care and birth experience.’
The Duchess of Sussex is famously tight-lipped when it comes to her family life.
Sources told the Daily Mail she stayed at a London hospital overnight before her son Archie Mountbatten-Windsor was born at 5.26am on May 6.
The Mail previously revealed Meghan planned to have a home birth, although sources acknowledged she was willing to go hospital if that was what was best for the baby.
Experts warned that as a 37-year-old, first-time mother, there would be a strong chance the Duchess would require some sort of medical intervention.
Peter Bowen-Simpkins, a consultant obstetrician and gynaecologist, told the Daily Mail: ‘When you have your first baby you essentially have an “untried pelvis”.
‘You don’t know what’s going to happen when the body prepares for labour and birth.’
Former Victoria’s Secret model Gisele also defied doctors’ advice when she gave birth to her two children.
In her book, Lessons: My Path to a Meaningful Life, she admits she ignored medical advice when she insisted on giving birth to her eldest son Benjamin in the bath at her home in 2009.
‘The doctor told me it was too dangerous for me to have a home birth,’ she wrote.
‘He said Benny was in an unusual position, my hips were too small, and the odds just weren’t in my favor.’
Gisele claims she ‘always dreamed of giving birth naturally, at home’ and has been wary of hospitals ever since her twin sister Pati developed double pneumonia when they were 10.
The model and her NFL-athlete husband Tom Brady welcomed their daughter Vivian, who was also born at home, in 2012.
Writing on her blog, Gisele said: ‘I am blessed to have had the opportunity to deliver at home, surrounded by love and where I felt safe.
‘It was a really great experience. I never felt so vulnerable but so strong at the same time,’ US Weekly reported.
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