The safety of home birth: the farm study.

Abstract

Pregnancy outcomes of 1707 women, who enrolled for care between 1971 and 1989 with a home birth service run by lay midwives in rural Tennessee, were compared with outcomes from 14,033 physician-attended hospital deliveries derived from the 1980 US National Natality/National Fetal Mortality Survey. Based on rates of perinatal death, of low 5-minute Apgar scores, of a composite index of labor complications, and of use of assisted delivery, the results suggest that, under certain circumstances, home births attended by lay midwives can be accomplished as safely as, and with less intervention than, physician-attended hospital deliveries.

Infant outcomes of certified nurse midwife attended home births: United States 2000 to 2004

“…Most studies examining neonatal mortality among pregnancies with planned home deliveries by certified midwives have found either no difference or lower neonatal mortality rates than among in-hospital births. [9][10][11][12][13][14][15][16][17][18][19] Several studies using less strict criteria for screening pregnancies for planned home birth or with less strict criteria for the certification of the attendant at delivery, however, have reported an increased risk of neonatal mortality for home births. 20,21 The primary objective of this analysis that was limited to term (37 to 42 weeks gestation), singleton, vaginal deliveries was to compare various adverse outcomes among infants delivered in-hospital by CNMs to the outcomes of infants delivered at home by CNMs in the United States for the years 2000 to 2004.…”

Perinatal Mortality in Nigeria: Do Place of Delivery and Delivery Assistants Matter?

“…On one hand, it is quite clear in the literature that unsupervised deliveries and those supervised by unskilled persons carry a significantly high risk of perinatal mortality. On the other hand it remains unclear whether delivery in a hospital is in itself safer than delivery at home under the supervision of a skilled attendant [15]. In other words, the debate in the developed world is focused on whether home deliveries are safer than institutional deliveries, considering that almost all births, whether occurring in a hospital or at home, are at least supervised by a skilled attendant.…”

Outcomes Associated With Planned Home and Planned Hospital Births in Low-risk Women Attended by Midwives in Ontario, Canada, 2003 to 2006: A Retrospective Cohort Study

“…Because adverse outcomes are infrequent, large samples are needed to detect important differences; however, the number of births occurring at home is not large in most Western countries. Studies of home birth have been limited by sample size (4,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24); absence of a comparison group (15,18,(20)(21)(22)(25)(26)(27)(28)(29)(30); comparison with care provided by other practitioners (17,23,24,29,31,32); use of self-reporting survey methods (25,27,30); or inclusion of both planned and unplanned home births (31,33).…”