Home birth should be considered a safe option for pregnant women

Visit my website to learn more about my services. This article was written in response to the publicity about the latest - and largest - homebirth study that revealed, by flawed measures, an increased mortality rate for home-born babies.

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Your article, in reporting the findings of a recent study that found home birth "carries three times the risk that her baby will die", may have unwittingly contributed to future mothers' unwarranted fears ...

Articles like this are worrying to read, particularly for pregnant women who may have been thinking they would like to have a home birth.

For a healthy woman with a straightforward, low-risk pregnancy, home birth is a safe option. The NCT's own detailed review of home birth concludes that there is no evidence that, for women with a low risk of complications, the likelihood of a baby dying during or shortly after labour is any higher if they plan for a home birth than if they plan for a hospital birth.

The safety of home birth is a contested issue. You stated that the review "considered a total of 342,056 planned home births and 207,551 planned hospital births". However, careful reading of the actual numbers reveals that the controversial evidence on "a near tripling of the neonatal mortality rate among infants" was based on just 15,633 planned home births, a number more than 20 times smaller. So it may have been a "big study in an influential medical journal", as you reported, but the outcome all the attention was based on was from a small sub-sample. These smaller numbers alone make the study's findings less reliable. But this study has a lot more limitations.

Women choose home births for varying reasons: they may want to be in their own space, getting comfort from their own familiar surroundings; they may want calm and privacy for their birth or access to a birth pool, or to minimise the risk of medical intervention. Some may have had a bad experience in hospital with a previous birth.

It is positive that you spoke to the president of the Royal College of Obstetricians, who confirmed ... that "mothers should not be alarmed about home birth as long as there is a transfer mechanism" in case of difficulty.

Luckily, the opportunity for home births is increasing in the UK, albeit slowly. In 2006, 39% of women said this had been discussed as an option at the start of their pregnancy, compared with 18% in 1995.

The home birth rate for the UK as a whole currently stands at 2.7% – but in Wales, where the government set a target for home birth, some counties have a rate of 8% or 9%.

Home birth should be considered a mainstream option ... and offered as a regular choice for pregnant women ... alongside birth centre care and care in a hospital maternity unit ...

Melissa Maimann, Essential Birth Consulting 0400 418 448