Hello all,

What do you say to people when you line up all the research that defends the safety of homebirth, and the person you're talking to says: "well, I heard that if a woman chooses to give birth at home, and then needs to be transferred to the hospital, and the baby dies at the hospital, the death counts as a hospital death....so who KNOWS if homebirth is REALLY safe?!?"

Please help me. I don't believe that these perspectives doubting home birth are trully evidenced-based, but I find myself not knowing how to proceed. Does anybody know how these stats are handled? Can anyone cite specific research/studies to help me out? I'm doing graduate studies, so I don't mind looking up a specific article is someone just tells me what it's called, when it was published....I don't mind reading through long articles. I just want to know how to answer this question. Just please throw me some leads. Somebody...anybody...lol...???

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Many studies have been conducted with samples of low risk women: half home birthing, half hospital. These studies have found that home birthing women have less intervention, less need for forced or surgical delivery, better Apgars for the infants, lower risk of perineal damage, and less risk of infection for both mother and baby. Mothers who deliver at home are also less susceptible to postpartum depression.

Also, you can spin it this way. If home birthing is supposed to increase the number of neonatal deaths in the US record, then you would expect that countries who do more home birthing would have higher neonatal death rates. The US ranks something like 45th in neonatal mortality (CDC), while less than 1% of births happen outside of hospitals. Sweden, Finland and other countries of northern Europe rank in the top 10 for neonatal mortality, and, in Sweden, all mothers are under the care of midwives. Many are home-bound, likely due to inclement weather.



Can you tell someone that they are perfectly safe delivering at home? Nope. Can you tell someone that they are perfectly safe delivering in a hospital? Nope. Just like there is a built in miscarriage rate, there is also a built-in complication rate. The population thinks that just delivering in a hospital makes it okay and safe to have a baby. One of the major complications that requires immediate assistance is uterine rupture. Most women don't even realize that there are MANY hospitals that don't have the facilities and staff to address this problem immediately. If the hospital does not allow VBACs, it is a good sign that they probably do not have the capacity to address uterine rupture immediately. The same can be said for uterine inversion.
Great points! I agree completely. I want to add that most of the catastophic complications that occur during birth (complete UR w/baby protruding into the abdomen, complete abruption, some pacental/fetal defects and cord wrapped several times around baby AND too short to allow delivery) require surgical delivery w/in about 4 minutes to save the baby and often the mom's uterus. NO hospital, no matter how well equipped they are can accomplish this. Thats why some babies don't survive birth. Its tragic but that's the reality of it. Thats part of the built-in complication rate you mentioned.
Thanks :)



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