How Safe Is Home Birth?
The largest scientific study comparing outcomes of home birth versus hospital
birth is Dr. Lewis Mehl and associates' "Home Birth Versus Hospital Birth:
Comparisons of Outcomes of Matched Populations."
In the study, 1046 homebirths were compared with 1046 hospital births of
equivalent populations in the U.S. For each homebirth patient, a hospital-
delivered patient was matched for age, parity, length of gestation, risk,
education, socio-economic status, race, presentation of the baby, and other
individual factors. The home birth populations had trained attendants and
The study shows a three times greater likelihood of Cesarean birth if couples
planned birth in a hospital instead of at home with hospital backup. The
hospital population experienced twenty times greater incidence of forceps, twice
as much use of oxytocin to accelerate or induce labor, greater use of analgesia
and anesthesia, and nine times greater incidence of episiotomy (while at the
same time having more severe tears in need of major repair.)
The hospital sample experienced six times more infant distress in labor, five
times more cases of marginal high blood pressure, and three times greater
incidence of postpartum hemorrhage. There was four times more infection among
the newborn; three times more babies needed help to begin breathing.
While the hospital sample had thirty cases of birth injuries, including skull
fractures, facial nerve palsies, brachial nerve injuries and severe
cephalohematomas (bleeding on the brain), there were no such injuries at home.
The infant death rate of their study was low in both cases and essentially the
same. There were no maternal deaths for either home or hospital. The main
differences were in the significant improvement of the mother's and baby's
health if the couple planned a homebirth, and this was true despite the fact
that the homebirth statistics of the study included those couples who began
labor at home but ultimately needed to be transferred to the hospital.
--excerpted from "The Five Standards for Safe Childbearing," by NAPSAC
International, P.O. Box 428, Marble Hill, MO 63764 U.S.A.