Midwives involved with home births are often not well integrated into the healthcare system in the United States and evidence on the safety of such home births is limited.
In the largest study of its kind internationally to date, researchers analysed over 5000 home births involving certified professional midwives across the United States and Canada in 2000. Outcomes and medical interventions were compared with those of low risk hospital births.
Rates of medical intervention, such as epidural, forceps and caesarean section, were lower for planned home births than for low risk hospital births. Planned home births also had a low mortality rate during labour and delivery, similar to that in most studies of low risk hospital births in North America.
A high degree of safety and maternal satisfaction were reported, and over 87% of mothers and babies did not require transfer to hospital.
"Our study of certified professional midwives suggests that they achieve good outcomes among low risk women without routine use of expensive hospital interventions," say the authors.
"This evidence supports the American Public Health Association's recommendation to increase access to out of hospital maternity care services with direct entry midwives in the United States."