Home birth

There is now strong evidence to say that homebirth is as safe as giving birth in hospital with many other psycho-social benefits.  Hutton et al (2019) state that ‘The risk of perinatal or neonatal mortality was not different when birth was intended at home or in hospital’.

The Birthplace Study which involved 17,000 cases showed that homebirth is just as safe as giving birth in hospital for second or subsequent births. A possible explanation for this is that labouring in hospital is much more likely to involve interventions, which can interfere with normal physiology and cause further problems such as postpartum haemorrhage (Downe, 2004).

In order for labour to progress oxytocin is needed, labouring people release this hormone when they feel safe and cared for. Their environment needs to be quiet, dark and free from disturbances. Home, can therefore offer an ideal environment for birth. However, each labouring person will have different preferences, some may be able to relax at home but some may feel safer in hospital. It is important that birth partners are fully supportive and of a similar mind-set in order to act as an advocate.

To summarise, the Birthplace study found that:

• When you are having your second or subsequent birth, homebirth is no less safe than birthing in hospital.
• For women having subsequent babies there is a significantly reduced chance of having a caesarean section, instrumental birth or episiotomy if they labour and birth at home or in a midwifery led unit.
• For women having their first baby at home, there is a slight increase in complications. There was a 0.9% chance of adverse perinatal outcomes compared to a 0.5% for women who had had given birth before.
• For women having their first baby at home, the transfer rate into hospital is significantly higher than for women having subsequent births; 45% compared to 10%. 

References

The Birth Place study Birthplace in England Research Programme | SHEER | NPEU (ox.ac.uk)

Downe, S. 2004. Normal Childbirth evidence and debate. Elsevier. London