BirthWise Maternity Care, LC

Bringing Birth Home    

The long-awaited study of home births attended by CPMs during the year 2000 is finally here: Outcomes of planned home births with certified professional midwives: large prospective study in North America. Kenneth C. Johnson, senior epidemiologist, Betty-Anne Daviss, project manager. 2005. BMJ; 330:1416 (18 June).

 

Published in the June 18 issue of the North America British Medical Journal, the study found that "planned home births for low risk women in the United States are associated with similar safety and less medical intervention as low risk hospital births," according to the BMJ press release (see below).

 

According to co-author Ken Johnson, this is the largest study of its kind at this time. The study is prospective (initial data submitted before the birth took place, so no births could be "left out") and includes data from more than 5000 births in the United States and Canada. It cannot be written off for being too small or not relevant to U.S. populations and circumstances.

 

The following is excerpted from a BMJ Press release:

 

Planned home births for low risk women in the United States are associated with similar safety and less medical intervention as low risk hospital births, finds a study in this week's BMJ. In the largest study of its kind internationally to date, researchers analyzed more than 5000 home births involving certified professional midwives across the United States and Canada in 2000. Outcomes and medical interventions were compared with those of low risk hospital births.

 

Rates of medical intervention such as epidural, forceps and caesarean section, were lower for planned home births than for low risk hospital births. Planned home births also had a low mortality rate during labour and delivery, similar to that in most studies of low risk hospital births in North America. A high degree of safety and maternal satisfaction was reported, and more than 87% of mothers and babies did not require transfer to hospital.

 

"Our study of certified professional midwives suggests that they achieve good outcomes among low risk women without routine use of expensive hospital interventions," say the authors. "This evidence supports the American Public Health Association's recommendation to increase access to out of hospital maternity care services with direct entry midwives in the United States."

 

The press release does not point that it was conducted by two Canadian researchers who live in Ottawa—a Canadian epidemiologist and a Canadian midwife. It was carried out on all clients having a delivery with a certified professional midwife for a given time period and reports on 5,418 births. The majority of the births were attended by American midwives, but Canadian midwives were also included in the study.