Planned home birth presents little risk where midwifery is well integrated – Eurasia Review

In Washington state, a planned home birth with a licensed midwife is just as safe as a birth at a licensed birthing center.

Researchers at the University of British Columbia and Bastyr University (Wash.) Came to this conclusion after analyzing the results of more than 10,000 community births in Washington state between 2015 and 2020.

The research team of midwives, epidemiologists and obstetricians published the results in Obstetrics and Gynecology.

“The birth setting had no association with an increased risk to the parents or the baby,” said Elizabeth Nethery, a doctoral student at UBC’s School of Population and Public Health and lead author of the study. . “Our results show that when a state has systems to support the integration of community midwives into the health system, as Washington has done, birthing centers and homes are both safe places to live. ‘childbirth.”

Home birth remains controversial in the United States The American College of Obstetricians and Gynecologists (ACOG) has said childbirth is safer in a hospital or licensed birthing center. They advise against home births because of studies that show higher rates of neonatal deaths among home births in the entire United States.

However, states vary widely in their licensing requirements, regulatory status, and access to medications for midwives. These variations could contribute to differences in results at the state level which are reflected in the figures at the national level.

Washington has done more than most other states to integrate midwifery into the health care system. It has one of the highest community birth rates in the United States, with at least 3.5% of all births (approximately 3,000 per year) to midwives at home or at an approved birthing center. by the state.

The result is a low rate of 0.57 perinatal deaths per 1,000 births, which is comparable to other countries where home births are well integrated into the health system. It is also identical to the ACOG benchmark for low risk births.

“Washington offers a model of safe community obstetric care and childbirth that could be replicated across the United States,” Nethery said. “Currently, some states in the United States currently have no license to practice available for community midwives, and this could be contributing to poorer birth outcomes in those states.”

The study analyzed data from 10,609 home and birth center births to midwives who are members of the state’s largest professional midwifery association. Births followed professional association guidelines and met regulatory standards for births at birthing centers in Washington State. This included people with healthy pregnancies who were carrying to term without a history of cesarean delivery and a fetus referred to head-first delivery.

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