January 20, 2020

Home Birth – What you should know about safety and choice

Choice of Birthplace. Home birth. Nothing else about midwifery care stirs more emotion than home birth. For some people, the response is very positive. But for many pregnant people, their partners, family, friends, co-workers, other health care providers, cashiers, hair dressers and the dog walker, the knee jerk reaction to the idea of home birth is shock. 

It is sad but not surprising, given that the vast majority of people in North America give birth in a hospital. People (for good reason) trust that we have an excellent medical system and that hospital birth provides experts and resources to keep people safe during the birth process. It is unfortunate, however, that people do not dig just a little deeper and consider that there may be other – equally safe – options.

5987_507319412651674_56556903_n

I won’t try to cover every aspect of choice of birth place in this blog post. If you have a midwife, you will have lots of time and opportunity to delve deep and make a decision that is right for you. I only hope to provide a very brief overview of why one might consider a home or birth centre birth and encourage you to keep an open mind.

What does the research say about the safety of home birth?

We are lucky that there is good research from Canada and other places in the world where midwives are well integrated into the health care system. The research consistently shows that midwifery clients who plan a home birth are well screened for potential risks and complications and have outcomes that are just as safe as those who plan to give birth in the hospital – but, they have lower rates of interventions and complications.

What does this really mean? It means that there are no more deaths or disabilities resulting from planned home birth compared to planned hospital birth in a setting like Ontario. It means that low risk people who plan a home birth are less likely to experience a cesarean section, episiotomy, significant tearing and abnormal bleeding. 

It is important to note that if you are at low risk when you go into labour then serious complications are rare regardless of where you choose to give birth and regardless of whether you have a midwife, family doctor or obstetrician. Giving birth in an Ontario hospital, birth centre or at home are all safe options. If you are interested in looking specifically at the research outcomes, check out the Association of Ontario Midwives Choice of Birthplace: Guideline for Discussing Choice of Birthplace with Clients. The document is written for midwives. It is heavy on statistics. But the recommendations are a clear and helpful summary of the research. It also includes a list of 39 references.

The safest place to plan a birth depends on you and your circumstances. Are you low risk? Do you have access to a skilled midwife? Can you travel safely to a hospital in labour? Does your local hospital provide maternity care? Do you have a history of really fast births? What are the road conditions? Where do you feel safe? Speak to your midwife to discuss all of the many variables that impact your safety.