Gentle Birth Care

Home Birth

Women choose to have their babies at home for a variety of reasons:

• Continuity of care—It is comforting to know that the familiar caregiver a woman has gotten to know during prenatal care, will be the same one attending the labor and birth.
• Natural Birth--Protecting the integrity of the birth experience is one of the primary reasons families choose home birth. At home, women establish their own birth rhythm with minimal disruption rather than following a hospital routine where medical interventions, although frequently lifesaving and necessary, are at times overused; and legal and financial considerations can outweigh even medical evidence.
• Privacy--At home, women have the flexibility to include whomever they choose to be present for labor, exams, and for the birth.
• Children—It is often easier for siblings to accept a new baby when they actively participate in the preparations. Children have the opportunity to get to know the midwife during prenatal visits. Depending on the parents' wishes, they may attend the birth, coming and going throughout labor; come into the room immediately after the birth; or even wake up in the morning to welcome the new baby.
• Waterbirth—Waterbirth is believed by many to be the gentlest of gentle births. Relaxing in warm water during labor gives support, comfort, and increased freedom of movement to the mother, and a more peaceful transition for the baby.

Planned Home Births Are Safe
The largest study of home births attended by Certified Professional Midwives, as published in
the British Medical Journal, has found that home birth is safe for low risk women and
involves far fewer interventions than similar births in hospitals.

Safe & Healthy Outcomes

• Results are consistent with most studies of planned home births and low risk hospital births
• Zero maternal deaths
• Intrapartum and neonatal mortality: 2.0 per 1000 intended home births (1.7 per 1000 intended home births when planned breech and twin births are excluded)
•  Immediate hospital transport for neonatal concerns resulted in just 2.4% of those newborns placed in neonatal intensive care
• At six weeks well over 90% of mothers were still breastfeeding their babies

Low Rates of Medical Intervention

• Much lower rates of interventions for intended home births compared to low risk hospital births:

* These numbers differ from the BMJ article where data for CPMs included forms of induction and stimulation
only used by midwives and not comparable to hospital births.

**According to the Center for Disease Control, in 2006 the cesarean delivery rate rose to 31.1 percent of all births, a record high in the U.S.

Satisfied Mothers

• Only 1.7% of the mothers said they would choose a different type of caregiver for a future pregnancy

Few Transfers to Hospital Care

• 12.1% transferred to hospital in labor or postpartum
• Five out of six transfers were before delivery--most for failure to progress, pain relief or exhaustion
• Midwife considered transfer urgent in 3.4% of intended home births

High Credibility

• Included all home births involving Certified Professional Midwives in the year 2000
• 5,418 women in U.S. and Canada who intended to give birth at home as of the start of labor
• Prospective – every planned home birth was registered in the study prior to labor and delivery

“Outcomes of planned home births with certified professional midwives: large prospective study in North America.”

Kenneth C Johnson and Betty-Anne Daviss. BMJ 2005;330:1416 (18 June). This article and related letters to the editor are available online, free, at http://www.bmj.com. (Use the search feature and type Daviss for the author.)