Midwifery Care
Homebirth Services

The Safety of Homebirth

The U.S. spends more on healthcare than any other industrialized nation yet we continue to rank 24rd for perinatal mortality/morbidity. Those nations that exceed us have one thing in common, and that is that over 70% of their births are attended solely by midwives. Never is there a doctor in the room. These countries include Denmark, Sweden, Holland and the Netherlands. In the U.S. approximately 8% of births are attended by midwives and only 1% is homebirths.

Currently in 20 other countries more babies survive their first month of life. Yet hospital costs in the U.S. for a typical hospital delivery have more than doubled in the past decade.

In 2005 the British Medical Journal published the MANA 2000 study, the first ever large-scale prospective study of the safety of homebirth in North America. This study illustrated that homebirth with a Certified Professional Midwife (CPM) is as safe as a low-risk hospital birth. The cesarean section rate for attended homebirths in 2000 was 3.7% vs 19.1% for intended hospital births. Additionally, the rates of interventions were consistently half that of hospitals. Most importantly, there were no fewer babies dying or injured in hospital than at home. The satisfaction of homebirth women vs hospital birth women was significantly higher with 97% of women reporting satisfaction with their homebirths.

The latest report from the Centers for Disease Control lists the nationwide cesarean section rate as 29.1%, with some areas of the country approaching 50%. A woman has a four times greater chance of dying from a c-section than she does in vaginal birth. Most common causes of death are infection and hemorrhage. Homebirth midwives maintain a c-section rate below 10% which is in alignment with the World Health Organization's (WHO) recommendation of 10-15%. Ironically, with the advancing c-section rate we have not seen a decline in the number of babies dying during childbirth nor the number of babies born with cerebral palsy.

A woman's chance of dying during pregnancy or birth in the U.S. has not decreased in more than 25 years despite all the advances in technology now commonplace in the birth room.

The WHO and the American Public Health Association both endorse out of hospital births with a trained midwife as a reasonable alternative to the high tech/high cost medicalized birth found in hospitals.