Although the reasons for deciding to give birth at home vary, most families in this country who choose home birth share a belief that birth is a natural physiological process, not a medical condition which routinely needs intervention, and therefore can safely take place outside the hospital. Also common is the feeling that labor, birth, and early newborn / parent interaction are events which are facilitated and enhanced by the continuity, security, and familiarity of the home environment. In addition, for some families, the decision to birth at home may be driven by a desire to take greater personal responsibility for the entire birth experience. A wish for more decision-making authority is often a motivating factor when families have had a disappointing previous hospital experience and wish to have a more enjoyable subsequent birth. Whatever your reasons for considering home birth, you can rest assured that for healthy, low-risk women experiencing normal pregnancies, studies indicate that home birth with a trained attendant can be a safe option.
Safety of Homebirth
Virtually all well-designed* studies of planned home birth with a trained care provider have found that for healthy, low-risk women, home birth is as safe or safer than hospital birth. The World Health Organization, Midwives Alliance of North America, and the American College of Nurse Midwives all recognize attended home birth as a safe option for all low-risk women.
To maximize the safety of home birth, a pregnant woman should be in good overall health and should maintain healthy habits and good nutrition during pregnancy. A home birth care provider should check for potential risk factors, and screen out women who have complications which might compromise the safety of home birth. The risk of some factors, such as vaginal birth after cesarean (VBAC) may be determined on an individual basis when compared to other factors (general well-being and health of the mother, reason for previous cesarean, etc.). For more information on Homebirth After Cesearean (HBAC) go here: http://www.rabn.org/pdf/HBAC.pdf But remember, criteria for home birth may differ between providers.
A Canadian study published in the British Medical Journal in 2005 showed that planned home birth for low-risk women in North America using certified professional midwives was associated with lower rates of medical intervention, but similar intrapartum and neonatal mortality to that of low-risk hospital births in the United States. It also showed that homebirth lowers the risk of cesarean. This supports the findings of all previous studies that were properly controlled*.
Research from 2014 (Cheyney) found “Low-risk women – – experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes”. A 2013 study from de Jonge, et al. published in the British Medical Journal found that complications were fewer in the homebirth setting than in the hospital setting. Also, two studies published in 2009, from the UK and Canada, and the Cochrane database review from 2012, also showed that homebirth with a registered Midwife was as safe for low risk women as a hopsital birth, with fewer interventions.
Now, in 2016 ACOG (The American Congress of Obstetricians and Gynecologiss) released a new OPINION on homebirth. They are getting closer to acknowledging the truth of the safety of homebirth, but they are still having difficulty admitting it. Be aware that ACOG is a trade union for Obstetricians. They do not rule the industry, and can only suggest protocols. They are in direct competition with Midwives, and homebirth, so be aware that their opinions are rather biased toward their business.
The latest analysis of recent homebirth studies can be found on the Science & Sensibility website. Henci Goer reaffirmed what we already knew.
* Well-designed studies compare low-risk women having planned, midwife-attended home births with low-risk women giving birth in hospitals. Some poorly designed studies suggested that home birth was not safe, but these studies were done using raw data from birth certificates alone. In those studies, all babies born outside a hospital or birth center, including unattended homebirths, unplanned homebirths, precipitous premature births, etc. were factored in when calculating morbidity and mortality rates, which alters the accuracy of the study.
So in conclusion, as long as a woman is healthy and low risk, has planned the birth at home (as opposed to an emergency birth), and has hired a birth attendant (as opposed to unattended. In NY this would be a licensed Midwife) the statistics show that she can have a safe, healthy birth at home.
Sources (Contact Amy Haas for a complete reference list at firstname.lastname@example.org)
- Goer H., Obstetric Myths Versus Research Realities.Bergin-Garvey, 1995
- American Journal of Public Health 1992:82:450-453
- Birth 1994:21:141-148
- Johnson & Daviss, British Medical Journal, 2005;330:1416
- Romano, L.; “A. Birth can safely take place at home and in birthing centers.” J.Perinat Educ 2007;16(Suppl 1):81S-88S.16
- Fullerton, J., Navarro, A. and Young, S. (2007). Outcomes of planned home birth: An integrative review. Journal of Midwifery & Women’s Health, 52(4), 323-333.
- de Jonge A, van der Goes B, Ravelli A, Amelink-Verburg M, Mol B, Nijhuis J, Bennebroek Gravenhorst J, Buitendijk S. Perinatal mortality and morbidity in a nationwide cohort of 529 688 low-risk planned home and hospital births. BJOG 2009; DOI: 10.1111/j.1471-0528.2009.02175.x.
- Jassen, et al; “Outcomes of planned homebirth with registered Midwife versus planned hospital birth with midwife or physician”. CMAJ 2009. DOI:10.1503/cmaj.081869
- Hutton, et al, “Outcomes associated with planned home and planned hospital births in low-risk women attended by midwives in Ontario, Canada, 2003 -2006: A retrospective cohort study”; Birth 36(3):180-89, 2009.
- Home Birth Annotated guide to the literature 2012
- Olsen O, Clausen JA. Planned hospital birth versus planned home birth. Cochrane Database of Systematic Reviews 2012,
Issue 9. Art. No.: CD000352. DOI: 10.1002/14651858.CD000352.pub2.
- de Jonge, et al ; Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study; BMJ 2013;346:f3263 http://www.bmj.com/content/346/bmj.f3263
- Catling-Paull, et al; Publicly funded homebirth in Australia: a review of maternal and neonatal outcomes over 6 years; Med J Aust 2013; 198 (11): 616-620.
- Cheyney, M., Bovbjerg, M., Everson, C., Gordon, W., Hannibal, D. and Vedam, S. (2014), Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009. Journal of Midwifery & Women’s Health, 59: 17–27. doi: 10.1111/jmwh.12172
- For Low-Risk Pregnancies, Home Births Just as Safe as Hospital, 12/22/15
Zielinski, et al; Planned home birth: benefits, risks, and opportunities; Int J Womens Health. 2015; 7: 361–377. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399594/
- Hutton, E. K., Cappelletti, A., Reitsma, A. H., Simioni, J., Horne, J., McGregor, C., & Ahmed, R. J. (2015). Outcomes associated with planned place of birth among women with low-risk pregnancies. CMAJ.
- Goer, Henci; “Dueling Statistics: Is Out-of-Hospital Birth Safe?” Science & Sensibility, Jaunary 5th 2016. http://www.scienceandsensibility.org/homebirth-safety/
- Planned home birth. Committee Opinion No. 669. American College of Obstetricians and Gynecologists. Obstet Gynecol 2016;128:e26–31. http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth?IsMobileSet=false
Out-of-Hospital Birth Shown to Be Safe & Effective . . . Again. (Henci Goer – 2017)
The following books should be available in local bookstores and libraries. If you have trouble locating them, most homebirth care providers have lending libraries. (See also the Recommended Reading List, with links to the Monroe County Library and Amazon.com, where a portion of your purchase will go to RABN!)
A Wise Birth, by Penny Armstrong and Sheryl Feldman
This beautifully written book chronicles the true story of Pennsylvania midwife Penny Armstrong as she serves and learns from a traditional Amish community.Â Possibly the best book ever to convey through simple stories the awesome power and beauty of natural unimpeded labor and birth.
Ina May’s Guide to Childbirth and Spiritual Midwifery, by Ina May Gaskin
These books combine practical information on preparing for and attending a home birth with dozens of home birth stories and photos emphasizing the intuitive, spiritual, and relationship-building aspects of home birth. Contains especially useful information for anyone having trouble finding a home birth provider.
Homebirth, by Sheila Kitzinger
This book is a gentle introduction to the beauty and sensibility of birthing at home. It is highly recommended for anyone contemplating or planning a home birth. In addition, it has been reported by many as very helpful in helping to ease the anxiety of reluctant family or friends. It includes information on preparing for a home birth.
Local Home Birth Providers:
Brigitte Rhody, CNM, MS – Midwifery & Women’s Health, Homebirth, Holistic health, Fertility & Wellness 585-737-0773; Rochester NY 14618, email@example.com Presently only accepting patients for well-woman GYN care.
Welcome Home Midwifery Meg Grindrod, CNM , Martha Boudakian, CNM, & Christina Kranz, CNM. Homebirth care, Well woman annual exams, Family planning, Special interest in VBAC (585) 271-7501; 2425 Clover St, Rochester, NY 14618. Welcome Home Midwifery !
September Hill Midwifery – Debora Bissonnette, CNM ; Two locations: 3808 Main Street, Burdett, NY, 14818, & locally: 421 Penbrooke Road, Suite 3 Penfield, NY 14625 (585) 388-6086 www.septemberhillmidwifery.com 607-546-7936 firstname.lastname@example.org Services: Preconception Counseling, Nutritional Counseling, Functional Medicine, Prenatal Care, Home birth, Lactation Support, Gynecological Services, Natural Family Planning/Fertility Awareness, Peri/Post-Menopausal Support.
Congratulations to Midwife Meg Grindrod on her 1000th Birth!
For a instructions on obtaining a list of other local midwives see our Provider Guide/Midwives page.
For additional information on HBAC (homebirth after cesarean ) click here http://www.rabn.org/pdf/HBAC.pdf
Rochester Homebirth Circle
Rochester HBC is for anyone who is planning or is interested in home birth, and for families to come and share their home birth experience. We meet on the 4th Sunday each month from 1-3 pm at Beautiful Birth Choices, 1100 University Ave, Building 4 – Entrance B, Suite 310, Rochester , NY 14607.
For more information on Homebirth Circle, having a homebirth, or to speak with someone who has had a homebirth, contact:
Insurance Coverage – NY State:“While home births are not specifically mentioned in New York Insurance Law § 4303(c)(1), if supervision of a home birth is within the scope of practice of a midwife, the HMO would have to provide coverage for such services.” “Since coverage of a midwife is included within maternity care, New York Insurance Law § 4303(c)(1), it is covered under Healthy New York. If an HMO does not have a midwife who assists in home births in its network, it must allow the prospective mother to access such a midwife, so long as that provider meets the minimum requirements of the plan, who is not in the HMO’s network.” http://www.dfs.ny.gov/insurance/ogco2005/rg050409.htm