Are Home Births Safe?

The Other Side of the Spectrum

The opinion of the American College of Nurse-Midwives (ACNM) is that home births are safe for healthy women who have a skilled midwife and timely access to immediate medical care if it is needed. The ACNM also states that childbirth has inherent risks, and that each birth setting has its own particular sets of risks and benefits. They also hold the position that each woman has her own belief system and must evaluate which set of risks and benefits are in her and her family's best interest.
 
The ACNM also reported that complications for mothers and babies that come from high rates of inductions, C-sections, and other overused interventions in U.S. hospitals are well documented and cause for concern. Other findings showed that there was no significant statistical difference in the outcome in terms of maternal or perinatal mortality (death) between births in and out of the hospital. However, there was increased morbidity (the rate of incidence of a disease) in the hospital.
 
According to the ACNM, every woman has a right to an informed choice as to where she wants to give birth and have access to safe services. They also state that CNMs and CMs are maternity care professionals who are trained and experienced to safely provide antepartum, intrapartum, and postpartum newborn care in the home. The ACNM also reported that collaboration among all healthcare providers is essential to ensuring a safe transfer of care from home to a hospital setting if necessary.
 
The ACNM states that women's bodies are uniquely made for pregnancy and childbirth, and when that natural process is encouraged, fewer complications occur. The facts listed by the ACNM include the following:
 
  • Research has shown that a familiar and comfortable setting will allow the body's physiology to naturally reduce pain and make labor more effective
     
  • Each intervention can cause a cascade effect of needing another intervention, which can lead to unnecessary complications or infections
     
  • Without drug intervention, babies are less likely to experience complications
     
  • While the rate of C-sections in the United States has risen to nearly 30 percent, the risk of having to transfer from your home to a hospital for a C-section is 3.8 percent.
 
Based on their values, the ACNM believes that childbirth is a natural process that has profound meaning to many mothers and should be treated as normal until there is evidence of a problem. Their approach is time-intensive and relationship-intensive, using physical and emotional methods to encourage, support, and care for a woman, as she is well designed for birth. Thus, it is the stand of the ACNM that midwives who practice in accordance with the midwifery model handle birth as a normal part of pregnancy and that it should be treated as normal until there is evidence of a problem.
 
(Click Finding a Midwife Who's Right for You for more information.)
 
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