Mothers shouldn’t put babies at risk with home birth, editorial says

Controversy about the pros and cons of home birth has raged this summer. Earlier this month, a study was published in the American Journal of Obstetrics & Gynecology that concluded home birth can be harmful to babies -- tripling the risk of infant death. Home births are on the upswing in several countries; now totaling 1% of all births in the United States (25,000 deliveries per year), 3% in Britain and more than 30% in the Netherlands.

But the new data on risks should be cause for reevaluating the practice, said editors of the Lancet in a commentary released Thursday. Although home birth is safe for low-risk mothers and has advantages to the mother, such as a shorter recovery time and fewer infections, the evidence of benefit for the baby is lacking, the editorial states.

“Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk,” the editorial states. But the commentary added: “Home delivery is an option for mothers with uncomplicated pregnancies, provided they are advised of the risks involved, have one-to-one midwife care (that includes good resuscitation skills and accreditation by a local regulatory body), and live in a location that allows quick access to obstetric care.”

The major risk to babies from home birth, the authors said, are breathing difficulties and failed resuscitation attempts.

However, the American College of Nurse-Midwives has disputed the findings of the study in the American Journal of Obstetrics & Gynecology.

“It is important to note that the authors’ conclusion differs significantly from findings of many recent high-quality studies on home birth outcomes which found no significant differences in perinatal outcomes between planned home and planned hospital births,” reads a statement issued by the group earlier this month. “We therefore caution against over-interpretation of these findings until there has been an in-depth review of this analysis which we will be conducting.”

Further analysis would be welcome for the women who are considering a home birth but now have no confidence in how to proceed.

-- Shari Roan

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