Is Home Birth in the United States Safe?

One day, I decided to type the question "Is home birth safe?" into Google. I tried two variations - "Is home birth safe?" and "Is homebirth safe?"

In an excellent example of why we shouldn't trust everything we read on the internet, for both searches the "Google Answer Box" at the top of the page quoted an article by the Midwives Alliance of North America, which said: "In today's peer-reviewed Journal of Midwifery & Women's Health, a landmark study confirms that among low-risk women, planned home births result in low rates of interventions without an increase in adverse outcomes for mothers and babies."

The problem? This is a lie. Every study done on planned, midwife-attended home birth in the United States - including the study quoted in the answer box - has found significantly increased rates of babies dying at home birth. 

The study quoted in the Google Answer Box, titled "Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009" and done by the Midwives Alliance of North America, found that the rate of newborn death at homebirth was 5.5 times higher than the newborn death rate at hospitals. 

And the worst part? The MANA study relied on voluntary, self-reported numbers from home birth midwives. With obvious personal interests in making the numbers look better, is is likely that many negative outcomes were not reported by midwives. In all likelihood, home birth has even worse outcomes than found by their study.

Here's a break down of the numbers from the MANA study: 

The CDC Wonder Database (an excellent, extremely accurate source of information) shows that for the years of the study (2004-2009), the neonatal death rate for babies born in the hospital to a comparable sample group was 0.38/1000. The "MANA Home Birth Data 2004-2009" for that same time period found that "The overall death rate from labor through six weeks was 2.06 per 1000 when higher risk women (i.e., those with breech babies or twins, those attempting VBAC, or those with preeclampsia or gestational diabetes) are included in the sample, and 1.61 per 1000 when only low risk women are included."

That overall death rate - 2.06 deaths per 1,000 - is 5.5 times higher than the comparable hospital death rate, 0.38 deaths per 1,000. The death rate found for only low-risk home births - 1.61/1000 - was still 4.2 times higher than the hospital death rate. 

The study done by MANA, which they claim shows home birth is safe, shows that 4 to 5.5 times more babies die at home birth than at the hospital. 

Home birth in the United States is not safe.