Homebirth: Is homebirth really a safe birth option?

Pang and colleagues skew their presentation to portray homebirth in the most negative light.

  • They falsify the true consensus of the homebirth research. In the introduction, the authors cite three studies they claim show an increased risk of newborn death in planned homebirths with a trained attendant. Two of them report no such increase (2,13). The third study's authors note that their study's mortality rate exceeded those reported in other homebirth studies and conclude that the excess was due to births that were not low risk and were therefore inappropriate for homebirth (1). Pang and colleagues don't acknowledge any of the many studies concluding that homebirth is safe.
  • The study omits mention of any disadvantages of hospital birth. We know there must have been at least two: more C-sections and more vaginal instrumental deliveries because all homebirth studies find this (5). And, in fact, a study using Washington State data from the same time period reports that 1 in 5 first-time mothers had a cesarean and approaching 1 in 4 had a vacuum extraction or forceps delivery (8). These procedures introduce considerable risk. Compared with women having normal vaginal births, this same study found that women were more likely to be admitted to the hospital within the next six months for uterine infection, wound complications or blood clots (8). Another study using Washington State data looked at postpartum health (9). Women having cesareans or vaginal instrumental deliveries were substantially more likely to experience poorer physical and emotional postpartum health. We also know these procedures can cause long-term or chronic problems, and in the case of cesarean section, problems conceiving or in future pregnancies and births (4,6).
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