Safety of Home Birth

Education and Training

The education and training required of Licensed Midwives and Certified Professional Midwives assures high quality, personalized care during pregnancy and birth for low-risk pregnant clients.

Our years of experience, along with our training, allow us to recognize early signs of conditions that are not normal and refer those clients to appropriate care when needed.

Monitoring

During the birth process we monitor the fetal heart beat, vital signs, and progression of labor.

Research

While less than 2% of pregnant people choose planned out-of-hospital birth in the US, there are many studies comparing the safety of home birth and birth center births to hospital birth. Studies show that planned home or birth center births, for low-risk clients, attended by qualified midwives, are as safe, or safer than, hospital births. Overall, when birthing at home, interventions are reduced and satisfaction is increased.

Decades of research studies continue to demonstrate the safety of out-of-hospital birth for low risk childbearing people.

Safety Studies

• A 2021 study out of Washington state published in Obstetrics and Gynecology concluded that planned home births in Washington state had comparable safety outcomes to those in Canada, the U.K., and the Netherlands, all locations that have long standing integration of midwives and home birth in their healthcare systems. This study also confirmed no difference in safety outcomes between midwife-attended planned home births and births in a state-licensed, freestanding birth center. 
• The Cochrane Pregnancy and Childbirth Group published a study on planned hospital birth versus planned home birth in September 2012 concluding that:
  – Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications.

• A study out of McMaster University in Canada was published in September 2009, in the journal Birth comparing outcomes for midwife attended planned home births and midwife attended planned hospital births. That study concluded:
  – All measures of serious maternal morbidity were lower in the planned home birth group as were rates for all interventions including cesarean section (5.2% vs 8.1%).
  – Midwives who were integrated into the health care system with good access to emergency services, consultation, and transfer of care provided care resulting in favorable outcomes for people planning both home or hospital births.
• A 2009 study published in BJOG: An International of Obstetrics & Gynaecology compared perinatal mortality and morbidity between planned home and planned hospital births among low-risk pregnancies, and found no difference in safety.
• A 2018 study published in PLOS ONE affirmed that integration of midwives into the healthcare system is associated with higher rates of physiologic birth, fewer interventions, and fewer adverse outcomes for babies. In addition, this study found that Washington state ranked highest in the United States for our level of integration.
• A 2014 study published in Journal of Midwifery & Women’s Health reviewed outcomes for over 16,000 midwife-led planned home births from 2004 to 2009 in the United States. This prospective study compared safety data as well as rates of intervention to low-risk hospital births, and found that midwife-led home births were comparably safe to hospital births, while minimizing interventions.

• In a 2005 study, published in the British Medical Journal, evaluating the safety of home births in North America involving direct entry midwives, found that intervention rates were substantially lower than for low risk US clients having hospital births. The study concluded:
  – Planned low risk home births in North America attended by certified professional midwives were associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.
• A report released in Birth in 2019 finds a continuing increase in the percentage of out-of-hospital births in the US. This study examines out-of-hospital birth trends from 2004 to 2017: “Trends and State Variations in Out-of-Hospital Births in the United States, 2004-2017”.