Safety of Home Birth

    The United States ranks 24^th internationally among industrialized nations in infant mortality (6.76 infant deaths/1000 births in 2001).  Those nations with the lowest infant mortalitie rates have one thing in common; the majority of their births are attended by midwives.  If doctors and hospitals are what makes birth safe, why do we with 98% hospital births and 94% physician attended births, rank so poorly?  This leads me to believe that physicians and technology, in and of themselves, do not ensure a safer outcome.

   Although most people feel that hospitals are the safest place to give birth, there is no evidence to support this belief.  Statistics repeatedly demonstrate that home birth is safer than hospital birth for the healthy women with no serious health problems.  The issue here remains:  we must assume responsibility for our own choice, an informed choice.  A woman must decide what environment she feels is safest for her and her baby.   Many women do not appreciate the obstetrical approach to pregnancy: “a problem waiting to happen”.  The choice of home birth reflects a woman’s trust in the birth process and in her self.  She trusts that she has everything she needs inside of her self to birth her baby without artificial assistance.  Nothing can guarantee a perfect outcome.  Harriett Hartigan sums it up quite clearly:  “Birth is as Safe as Life Gets.”

 
Maine Home Birth Statistics 1994 to 1998

   The following data is from 349 planned home births with 8 midwives.  The data includes all transfers to the hospital and any procedures done there.

13 cesarean sections                                            3.7%

4 vacuum extractions                                          1.1%

0 forceps

Total surgical birth                                              4.8%

Transfers to the hospital                                   12.2%

First stage                                          6.8%

Second stage                                      1.5%

Third stage                                         0.3%

Postpartum                                        3.5%

Infant                                           0.5%

Maternal hemorrhage                   1.3%

Retained placenta                         0.3%

Other                                            1.5%

Maternal Deaths                                                  0

Neonatal Deaths                                                   4*

*All deaths were non-preventable and not related to midwifery or
home birth.

Spontaneous premature labor in twins at 24 weeks, transferred to
the hospital where born with birth weights of 595 gm and 539 gm,
both deaths within 24 hours.

Spontaneous premature labor at 26 weeks, transferred to the hospital where born with birth weight of 822 gm, death in less than 24 hours.

Potter’s syndrome (born with no kidneys), transferred to the hospital
and death in 3 hours.

 
Maine Birth Statistics 2001

 

All hospitals boast that their birth statistics are readily available to the public.  Unfortunately, this is not the case.  When inquiring about rates of cesarean sections or other birth-related statistics, the consumer is referred to the hospital billing office. All this information is available if you have the knowledge and patience to decipher hospital billing codes.  The average consumer is, of course, not likely to do this.  Hospitals are mandated to report annually to the Maine Health Data Organization in Augusta, and these reports are collected in billing codes.  This organization will translate these codes into usable information for a fee of $40.00/hour.  I paid $80.00 for the following information for seven hospitals in Central and Eastern Maine.  Because all women are not able to birth at home, I hoped this information might be useful in helping women to choose a hospital.

 

	Total# Deliveries	Percent C-Section	Ratio	Vacuum	Forceps	Artificial Induction
Blue Hill	160	18.1	1:6	1:20	1:160	1:27
Bangor	1,659	25.3	1:4	1:11	1:207	1:4
Ellsworth	166	22.3	1:5	1:33	0	1:14
Waterville	538	24.5	1:4	1:22	1:538	1:8
Mr. Desert Island	86	19.8	1:5	1:11	0	1:5
Lincoln	84	19.1	1:5	1:6	0	1:11
Belfast	212	27.8	1:3.5	1:53	1:42	1:4
Statewide	13,129	24.2	1:4	1:15	1:263	1:7
Midwives of Maine 1994 - 1998	349	3.7	1:27	1:87	0	0