How Safe Is Home Birth? The largest scientific study comparing outcomes of home birth vers

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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 prenatal care. 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.


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