New Study: Home Birth as Safe as Hospital Birth

Ahem!
Is anyone in the medical community paying attention?
This wasn't exactly a "small" study.
Will ACOG revise their radical stand opposing homebirth?
I'm just wonderin'. . .

Look at these rates:
Intrapartum death:
Home: 0.03% vs. Hospital: 0.04%

Intrapartum and neonatal death within 24 hours of birth:
Home: 0.05% vs. Hospital: 0.05%

Intrapartum and neonatal death within 7 days:
Home: 0.06% vs. Hospital: 0.07%

Neonatal admission to an intensive care unit:
Home: 0.17% vs. Hospital: 0.20%

It looks like people were just ever so slightly more likely to be "safer" at home. Hmm....
And as a side benefit, more happy and comfortable in their own beds and bathrooms and living rooms. Oh, and it cost less.

No matter where you have your baby, there is no guarantee that it will all turn out well or that you will like the outcome or that whatever happened couldn't have possibly been prevented in the opposite setting. BUT, to say that home is more risky than the hospital for healthy women...
Show me!!


NEW YORK (Reuters Health) Jul 28 -
In terms of perinatal morbidity and mortality, a planned home birth is as safe as a planned hospital birth, provided that a well-trained midwife is available, a good transportation and referral system is in place, and the mother has a low risk of developing any complications, new research shows.

"Low-risk women should be encouraged to plan their birth at the place of their preference, provided the maternity care system is well equipped to underpin women's choice," Dr. A. de Jonge, from TNO Quality of Life, Leiden, the Netherlands, and co-researchers emphasize in the August issue of BJOG: An International Journal of Obstetrics and Gynaecology.

Data regarding the safety of home births in low-risk women are lacking, due in part to the fact that studies with very large sample sizes are needed to assess relatively rare adverse outcomes. Moreover, randomized trials comparing home and hospital births have not been done because women usually want to choose their place of birth, the authors explain.

The present study, an analysis of 529,688 low-risk planned births, was conducted in the Netherlands, the only country in the west with a large enough data set. The group included 321,307 women who wanted to give birth at home, 163,261 who planned to give birth in the hospital, and 45,120 with an unknown intended place of birth.

All of the outcomes studied occurred with comparable frequency in the planned home and hospital birth groups. These included intrapartum death (0.03% vs. 0.04%), intrapartum and neonatal death within 24 hours of birth (0.05% vs. 0.05%), intrapartum and neonatal death within 7 days (0.06% vs. 0.07%), and neonatal admission to an intensive care unit (0.17% vs. 0.20%).

"As far as we know, this is the largest study into the safety of home births," the authors note. The findings, they conclude, indicate that with proper services in place, home births are just as safe as hospital births for low-risk women.

BJOG 2009;116:1177-1184.

What Do Women Really Want in Birth?

What do women really want in birth?

The answer to this question influences billions of dollars of business in our country every year.

Every wise business person knows that in order to be successful, s/he must develop a product that is what the consumer WANTS and/or NEEDS.

If the consumer wants it, but doesn't need it, s/he may or may not buy it.

If the consumer needs it, doesn't really want it or find the product attractive, s/he probably will go elsewhere to get what they need.

When you combine need and want, you have a powerful product.

Our current maternity care system has convinced most of their customers that what they offer is what the customers need and want.
But is it really?

What basic things have they convinced the majority of mothers to need and want?

Safety

Avoiding unnecessary pain

If you ask nearly any woman why she's having her baby in the hospital, her biggest reason will be "safety."
Ask her what other reasons, and you may get an assortment of answers, but most likely the most frequent answer will be "for pain relief" if she takes a moment to think about what her hospital and obstetrician offer her.

These are two good things for women to want.
Who wouldn't want their baby to be safe?
Who wouldn't want to know that if anything goes wrong, someone will know how to fix it?
And who wants to suffer unnecessary pain?

But are women really getting what they think they are?

Sometimes I see many pregnant women in our society akin to a man who keeps driving his little Chevy truck that breaks down frequently, and is convinced that his truck is the best that can be had, because all of his friends say so. Even books about buying a good truck say so. The man who sold it to him told him that it was the best kind of truck he could drive. Sure, he doesn't like the breakdowns, but he's been told that his truck is the best, so he does his best to live with the aspects he doesn't like and pride himself that he is driving the best truck anyone could buy.

How many women are taken by the marketing that occurs in this country? We tell them that if they would only come to the hospital, they might experience a few breakdowns and inconveniences, but their experience will be the best they will find anywhere - safe and comfortable.

That's what we say.
But is it true, or is our modern maternity care system not all its cracked up to be?