Home Birth

A home birth in developed countries is an attended or an unattended childbirth in a non-clinical setting, typically using natural childbirth methods, that takes place in a residence rather than in a hospital or a birth centre, and usually attended by a midwife or lay attendant with expertise in managing home births.

Women with access to high-quality medical care may choose home birth because they prefer the intimacy of a home and family-centered experience or desire to avoid a medically-centered experience typical of a hospital or clinical setting. Professionals attending home births can be obstetricians, certified midwives and doulas. Home birth was, until the advent of modern medicine, the only method of delivery. In developing countries, where women may not be able to afford medical care or it may not be accessible to them, a home birth may be the only option available, and the woman may or may not be assisted by a professional attendant of any kind.

The evidence regarding safety is difficult to interpret, as it is dependant on the country setting of care provided. The UK has a widwifery lead care both antenatally and post-natally, and women are only referred to joint midwife/obstetric care if indicated. National Institute for Health and Clinical Excellence reports that mortality in labour or childbirth for booked home births, regardless of the eventual place of birth, is the same as birth booked in hospitals (inclusive of Maternity Lead Units within Hospitals and Obstetric run units) .

In the USA, where there is no standard widwifery care provided, the American College of Obstetricians and Gynecologists advises that "although the absolute risk may be low, planned home birth is associated with a twofold to threefold increased risk of neonatal death when compared with planned hospital birth." A prior cesarean delivery increases the risk of uterine rupture (0.2% risk of rupture) and other complications and women wishing to attempt a vaginal birth after cesarean should do so only in a hospital with ready access to emergency care. Due to a greater risk of perinatal death, the College advises women who are postterm (greater than 42 weeks gestation), carrying twins, or have a breech presentation not to attempt home birth. A large 2009 study reported that, in the Netherlands, planned home birth led by a midwife at onset of labor "does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives and through a good transportation and referral system."