The popularity of home births has been rising in recent years. One question is whether they are as safe as in-hospital births. A new study in NEJM found that most home births are safe, but hospital births are safer. As the N.Y. Times reports:
The study analyzed nearly 80,000 pregnancies in Oregon, and found that when women had planned out-of-hospital deliveries, the probability of the baby dying during the birth process or in the first month after — though slight — was 2.4 times as likely as women who had planned hospital deliveries.
Out-of-hospital births also carried greater risk of neonatal seizures, and increased the chances that newborn babies would need ventilators or mothers would need blood transfusions.
On the other hand, out-of-hospital births were far less likely to involve cesarean sections — 5.3 percent compared with 24.7 percent in a hospital. They also involved fewer interventions to augment labor, and mothers had fewer lacerations.
The study used variation in where the expectant mothers planned to give birth so that there results were not biased by home birth cases where the patient was transferred to the hospital.
It is important to make sure that women are free to choose the birth experience that suits them best and that birth is made safer for mother and baby in all settings. Nevertheless, it is important for mothers to understand the risks inherent in both in hospital and home births.