The authors of the new study compared three different groups of planned births in British Columbia from the beginning of 2000 to the end of 2004: home births attended by registered midwives (midwives are registered in Canada), hospital births attended by the same group of registered midwives, and hospital births attended by physicians. In all, the study included almost 13,000 births.
The mortality rate per 1,000 births was 0.35 in the home birth group, 0.57 in hospital births attended by midwives, and 0.64 among those attended by physicians, according to the study.
Women who gave birth at home were less likely to need interventions or to have problems such as vaginal tearing or hemorrhaging. These babies were also less likely to need oxygen therapy or resuscitation, the study found.
The authors acknowledge that "self-selection" could have skewed the study results, in that women who prefer home deliveries tend to be healthier and otherwise more fit to have a home birth.
Janssen said she hoped "this article will have a major impact in the U.S." But there is a definite "establishment" bias against home births. And the issue is an emotionally charged one, she said.
"There is a political and economic issue about controlling where birth happens, but also a deep belief by physicians that it's not safe to have your baby at home," Greenfield said. "Doctors see every home-birth patient who had a complication, but we don't see the ones that have these beautiful, fabulous babies at home who may breast-feed better or have less hospital-acquired infections. There may be medical benefits," she added.
"Midwifery needs to be regulated. It can't be under the radar because then it's dangerous," Greenfield said. "There has to be a regulatory process and a licensure process [to protect] women who are going to choose home birth anyway."
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