Is home birth safe?
According to the most recent and up-to-date research evidence, yes.
A systematic review and meta-analysis has been published by The Lancet. It looked at 14 studies including data from around 500,000 intended home births. The authors found that, “The risk of perinatal or neonatal mortality was not different when birth was intended at home or in hospital.”
If you’re the kind of person that likes the detail, here are the results of the most recent study:
“Among nulliparous women intending a home birth in settings where midwives attending home birth are well-integrated in health services, the odds ratio (OR) of perinatal or neonatal mortality compared to those intending hospital birth was 1.07 (95% Confidence Interval [CI], 0.70 to 1.65); and in less integrated settings 3.17 (95% CI, 0.73 to 13.76). Among multiparous women intending a home birth in well-integrated settings, the estimated OR compared to those intending a hospital birth was 1.08 (95% CI, 0.84 to 1.38); and in less integrated settings was 1.58 (95% CI, 0.50 to 5.03).” (Hutton et al 2019).
These findings confirm those of the meta-analysis conducted by Scarf et al (2018). Studies also confirm other benefits of homebirth. For example, increased likelihood of breastfeeding success. When researchers asked fathers about their experiences of homebirth, they described it as magical.
Home birth isn’t just for those who manage to stay in the ‘low risk’ box either! Research shows that home birth is also safer for women who are labelled as ‘high risk’. (Let’s acknowledge that this labelling is often inaccurate, unhelpful and offensive though.) Here’s more evidence from The Netherlands and Australia. We also have papers from the US.
And I recently helped a colleague with putting the evidence on safety together for a book. Homebirth: Safe & Sacred. It was written by American homebirth midwife Kim Osterholzer. The book’s aim is to get information out to those who have questions in an affordable, readable format. It is written for a US audience, so some of the information about midwifery care is US-specific. But the stories and the evidence transcend national borders. You can find out more about the book here.