Home births have fewer interventions and adverse maternal outcomes: an international study
Prior research by McMaster University researchers has shown that babies born to low risk women intending to give birth at home have the same outcomes as those born to similarly low risk women who give birth in hospital. In this companion paper, McMaster researchers investigated outcomes among low-risk pregnant women who intend to give birth at home vs. in a hospital, specifically looking at the occurrence of birth interventions and maternal outcomes.
With the onset of COVID-19 pregnant women are once again needing to make difficult decisions about place of birth. Prior research by McMaster University researchers has shown that babies born to low risk women intending to give birth at home have the same outcomes as those born to similarly low risk women who give birth in hospital.
In this companion paper, McMaster researchers investigated outcomes among low-risk pregnant women who intend to give birth at home vs. in a hospital, specifically looking at the occurrence of birth interventions and maternal outcomes. The study found that low-risk women intending to birth at home have fewer birth interventions and adverse maternal outcomes. These findings along with earlier work from this team provide families, health care providers and policy makers with important information around safety of intended home birth.
“Our prior research has provided confidence for women in well-resourced countries who are choosing birth at home in terms of the welfare of their infants. This paper provides additional information in support of choice of home birth in terms of safety for mothers. Even though it is possible that women who intend to give birth at home are more intervention averse, for the women included in the wide variety of settings in our study, they had good outcomes with fewer interventions,” — Eileen Hutton, professor emeritus of obstetrics and gynecology at McMaster, founding director of the McMaster Midwifery Research Centre and senior author of the paper.
The study was undertaken at the McMaster Midwifery Research Centre (MMRC) and led by Eileen Hutton, professor emeritus of obstetrics and gynecology at McMaster University. The research team included Angela Reitsma (first author), Julia Simioni, Ginny Brunton, and Karyn Kaufman. This systemic review and meta-analyses included data from 16 published studies since 1990 that reported on maternal outcomes and intrapartum interventions. Over ~500,000 intended home births were included from 9 different countries: The Netherlands, England, Iceland, Canada, USA, New Zealand, Norway, Sweden, and Japan. Outcomes included in analyses were: post-partum hemorrhage, and maternal infection and birth interventions such as epidural analgesia, epidural, 3rd or 4th degree tear, oxytocin augmentation and operative vaginal and cesarean births. Women who intended to give birth at home were less likely to experience any obstetrical interventions or maternal complication.
The results have been published by The Lancet’s EClinicalMedicine journal. Find the article here.
The study was supported in part by a grant from the Association of Ontario Midwives.
Read the Brighter World profile on Eileen Hutton here.
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