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.
- MANA Study – This is the study mentioned above, released in 2014 by the Midwives Alliance of North America. It found a death rate 5.5 times higher at home birth (for breech babies the death rate was 28 times higher)
- Term neonatal deaths resulting from home births: an increasing trend – Study from 2014 that found a death rate 4 times higher at home birth than hospital birth
- Oregon Study – Study from 2012 that found a death rate 8 times higher at home birth than hospital birth
- Birth Outcomes of Planned Home Births in Missouri: A Population-Based Study – Study from 2011 that found that home birth resulted in a 5 times increase in neonatal seizures, and an 11-20 times increase in intrapartum (during labor) deaths.
- Infant outcomes of certified nurse midwife attended home births: United States 2000 to 2004 – Study from 2010 found that home birth with CNMs had 2 times more deaths as the hospital, and home birth with CPMs had 3.5 times more deaths than the hospital
- Neonatal Mortality of Planned Home Birth in the United States in Relation to Professional Certification of Birth Attendants – Study published in 2016 that found babies born to CNMs and CPMs at planned home births died three to four times more often than babies born at the hospital, with no statistically significant difference between CNMs or CPMs at home
- Home birth and risk of neonatal hypoxic ischemic encephalopathy – Study that found that home birth babies suffer 17 times as many brain injuries
- Selected perinatal outcomes associated with planned home births in the United States – Study that found that 3 times as many babies born at home have seizures
- Apgar score of 0 at 5 minutes and neonatal seizures or serious neurologic dysfunction in relation to birth setting – Study that found almost 4 times as many babies born at home have seizures, and 10 times as many babies born at home have a five minute Apgar score of 0
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.
.
