A US study including the results of more than 10,000 home births shows that these present little risk provided that a midwife is present.
- Although few midwives practice it, and the vast majority of gynecologists are hostile to it, home birth is safe if it is well supervised.
- The study, which takes into account more than 10,000 births in Washington State between 2015 and 2020, shows that the perinatal rate is 0.57 deaths per 1,000 births.
Each year in France, approximately 2,000 women choose to give birth at home, which represents 0.2% of births. Although still marginal, planned home birth tends to be increasingly considered by parturients, despite the reluctance of gynecologists and midwives. Rare are those who perform home births (AAD). According to’Professional Association of Accompanied Home Birth (APAAD), 88 midwives officially practicing AAD were counted in 2018, and they declared 1347 births that started at home.
Home births concern healthy women whose pregnancies were uncomplicated, who carried their pregnancy to term, without a history of caesarean section, and whose fetus was oriented upside down. In case of AAD, the midwife is alone with the pregnant woman and her partner. She has no equipment at her disposal (oxygen, blood bag, forceps or suction cup) to treat any complications. These, whether they concern the mother or the baby, will require transfer by ambulance to a hospital or clinic.
These births are nevertheless safe, both for the mother and her child. This is shown by a new study conducted in Washington State in the journal Obstetrics & Gynecology. Its authors, researchers at the University of British Columbia (UBC) and Bastyr University, came to this conclusion after analyzing the outcomes of more than 10,000 community births in Washington state between 2015 and 2020.
A low perinatal death rate
As Elizabeth Nethery, a doctoral candidate in the UBC School of Population and Public Health and lead author of the study, explains, “Birth setting had no association with increased risk for parents. or the baby”. “Our results show that when a state has systems in place to support the integration of community midwives into the health care system, as Washington State has, birthing centers and homes are all two of the safe places for childbirth.”
Although the American College of Obstetricians and Gynecologists (ACOG) has stated that birth is safer in a hospital or licensed birthing center, the results show that it is not. For example, in Washington State, researchers found a low perinatal death rate: 0.57 deaths per 1,000 births, which is comparable to other countries where home birth is practiced and well integrated. to the health system. It is also identical to the ACOG reference rate for low-risk births.
“Washington offers a model of safe community birthing and obstetric care that could be replicated across the United States, says Elizabeth Nethery. AT Currently, some US states do not allow midwives to perform community birth at all, which could contribute to poorer birth outcomes in those states.”
.