Homebirth: Is homebirth really a safe birth option?

The American College of Obstetricians and Gynecologists (ACOG) claim that a 2002 study shows that women planning homebirths have an increased risk of several complications, including twice the risk of newborn death (11).This new study flies in the face of numerous other reputable studies, all concluding that planned homebirth with a trained attendant is safe (3,5,7,12). These include a study carried out by the Washington State Department of Social and Health services using some of the same data (3).

It behooves us to examine this new study with a critical eye. When we do so, it reveals itself to be, at best, a piece of work done by obstetricians who have an axe to grind. At worst, its many omissions and misstatements may have been intentional.

Here are the study's flaws:

Design flaws render the Pang study incapable of determining whether planned homebirth is riskier than planned hospital birth.

  • The study doesn't match populations according to risk factors. Matching makes groups more alike and therefore more comparable. The researchers should have paired women according to whether this was a first birth, the baby had a heart defect or other serious congenital anomaly or the baby was born early. They should also have matched women planning birth at home with women using nearby hospitals. Otherwise, you aren't comparing apples to apples. Small hospitals lack the facilities and staff of sophisticated medical centers, and outcomes may be different when there are complications.
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