Are home births as safe as giving birth in the hospital?

Welcoming a new life into the world is one thing all expectant parents anticipate with a mix of emotions – excitement, apprehension, and everything in between. And with that anticipation comes an important question – where is the best place to have the baby?

For years, the medical community has debated this with passion. Are hospitals the only safe place for childbirth, or are homes and birth centers suitable options?

A breakthrough study, led by researchers at Oregon State University (OSU), may finally provide some clarity.

Pre-existing beliefs

For years, the American College of Gynecologists and Obstetricians has touted hospitals and accredited birth centers as the safest places to deliver a baby.

These facilities, unlike a typical home setup, are equipped with medical resources and personnel.

But wait, before we create a mental picture of birth centers as cold, sterile, and impersonal spaces, let’s clarify what they actually are. A birth center is a healthcare facility that offers a more home-like and natural environment than is found in a hospital.

Home vs. birth center

The Oregon State University team analyzed two national registries for community births – meaning planned births at home or in a birth center for low-risk pregnancies.

In this study, a low-risk pregnancy was defined as one involving a single baby being carried to full term, with its head positioned down, and no major maternal complications like diabetes or pre-eclampsia.

Interestingly, Marit Bovbjerg, an associate professor in the Oregon State College of Health, estimates that at least 70% of pregnancies are low risk.

The two registries documented over 110,000 births between 2012 and 2019 across all 50 U.S. states. And guess what they found? There was no difference in safety between home births and those in birth centers.

“Our study is the first to provide evidence that these two birth settings are equally safe,” declared Bovbjerg.

Safety of different settings

The research team included Marit Bovbjerg and Melissa Cheyney, a professor in the OSU College of Liberal Arts and a licensed midwife.

While they didn’t directly compare the safety of community settings to hospitals, they highlighted the growing body of evidence supporting the safety of planned community births.

Interestingly, this claim is supported by a U.S. National Academies of Science, Engineering, and Medicine report published in 2020.

Shift in perception

Bovbjerg and Cheyney’s study doesn’t just shed light on safety – it also reflects a shifting perception of childbirth.

Home births have been on the rise over the last two decades in the U.S. Currently, 2% of births happen within community settings, which include both home and birth center environments.

Why choose home births?

One might wonder why some expecting parents choose home birth. The reasons can be complex. One factor may relate to concern over negative hospital experiences.

“They might fear a loss of continuity of care provider, as well as possible mistreatment and judgment upon arrival at the hospital,” explained Cheyney.

Indeed, a national care-experience study reported instances of mistreatment, including being ignored, scolded, shouted at, or undergoing an invasive procedure without consent.

What if something goes wrong?

A common concern regarding home birth is the potential risk if complications arise. However, the reality is that midwives and healthcare professionals involved in home births are well-prepared to manage emergencies.

They are trained to recognize early signs of complications and are ready to transfer care to a hospital if necessary. The study by Bovbjerg and her team emphasizes that, with proper planning and risk assessment, home births can be a safe alternative for low-risk pregnancies.

This highlights the importance of a thorough prenatal assessment and the collaboration between midwives and nearby healthcare facilities to ensure a seamless transition if transfer becomes necessary.

Home births are a safe option

Insights from this study guide us towards improving the childbirth experience. For example, if hostile hospital experiences discourage necessary transfers, the logical solution is to improve these experiences.

“Transfer from community settings is often necessary, and anything that discourages a necessary transfer likely causes harm,” Cheyney cautioned.

With a shared goal – to make childbirth a safe, comfortable, and positive experience for all involved – this research encourages us to rethink traditional beliefs and recognize the safety and efficacy of diverse childbirth settings.

The future of childbirth may be more flexible and accommodating than we’ve ever imagined.

The study is published in the journal Medical Care.

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