About 1% of babies born in the United States are planned home births, while the rest occur in a hospital. However, according to the Cochran Library, an international independent research organization, home births may safer than hospital births in avoiding complications. The organization does caution that home births are safer for low risk pregnancies, not high risk pregnancies. It is also important that the midwife running the home birth be well-trained. As a medical malpractice lawyer, I found this study very interesting because a hospital birth should never be more dangerous than a home birth if executed properly.
According to the study, low risk pregnancies at home tend to have fewer complications than hospital births by 10-30% which, in turn, would seem to reduce the rate of medical malpractice lawsuits. A low risk pregnancy is a pregnancy that is anticipated to be problem free. Higher risk pregnancies are those that involve certain risk factors that suggesting a higher risk of complication than a low risk pregnancy. Of course, a low risk pregnancy can later be turn into a high risk pregnancy depending upon circumstances that may arise during pregnancy.
So how could a home delivery, in a low risk pregnancy, be safer than a hospital birth? One explanation is that hospitals pregnancies are often rushed along quicker than home births through various interventions. For example, many hospital births are accelerated when doctors use Pitocin to induce and/or speed up labor. However, with home births, midwives are trained to take their time even if it means a labor and delivery process that may take much longer than what would typically occur in a hospital. In the event a medical problem arises, a well-planned home birth must include backup plan where immediate transport to the nearest hospital can be accomplished if necessary.
Another explanation offered for why home births may be safer than hospital births is that medical interventions can lead to unintended results. For example, electronic monitoring can cause an artificial rupture of the membranes before nature intended which can cause complications. In addition, the use of Pitocin can increase the risk of fetal distress according to some studies.
Of course, there are certain risks of home deliveries that would be less common in hospital births. With state of the art equipment, including high tech fetal heart rate monitoring, hospital staff can respond quickly if the baby's condition begins to rapidly deteriorate which may require an emergency cesarean section. To the extent high risk pregnancies carry an increased rate of cesarean sections, most experts agree a high risk pregnancy should not occur at home.
Medical News Today, Home Births May Be Safer Than Hospital Births, September 19, 2012.
Childbirth.org, Pitocin FAQ, Viewed September 19, 2012.
ABC News, Are Home Births Dangerous, July 11, 2008.