Planned home births using certified professional midwives are safe for women at low risk for complications, reports the largest study to date on the subject. Thousands of women who underwent home births using midwives had lower rates of medical interventions such as epidural pain relief, forceps delivery and Caesarean section than similar women who give birth in hospitals. And babies born at home with the assistance of these midwives had no higher risk of death during delivery and after birth than low-risk, hospital-born babies. The findings are consistent with past research.
Safety First The study, published in the British Medical Journal, followed 5,418 women expecting to deliver at home in 2000 with the aid of midwives certified by the North American Registry of Midwives.
About 12 percent of the women were transferred to a hospital during labor because of complications. After delivery, 1.3 percent of the mothers and 0.7 percent of newborns were sent to a hospital, mostly for maternal hemorrhage, respiratory problems in the baby and retained placenta. No mothers died. There were 1.7 infant deaths per 1,000, a rate "similar to risks in other studies of low-risk home and hospital births in North America," the study reports.
Legal Notes Nurse-midwifery is legal in all 50 states and the District, according to the American College of Nurse-Midwives (ACNM). In Maryland and the District, midwives must have a nursing degree to attend births. In Virginia midwives without a nursing degree will be permitted to attend births, starting in July. The ACNM recommends that women seeking midwives look for people with degrees from accredited midwifery educational programs tied to higher educational institutions. All ACNM certified midwives have at least a bachelor's degree; more than 70 percent have at least a master's degree, reports the ACNM. The American College of Obstetricians and Gynecologists opposes home births, citing safety concerns.
-- January W. Payne