Eideard

The risk of infant death following planned home birth attended by a registered midwife does not differ from that of a planned hospital birth, found a study published in CMAJ (Canadian Medical Association Journal).

The study looked at 2889 home births attended by regulated midwives in British Columbia, Canada, and 4752 planned hospital births attended by the same cohort of midwives compared with 5331 physician-attended births in hospital. Women who planned a home birth had a significantly lower risk of obstetric interventions and adverse outcomes, including augmentation of labour, electronic fetal monitoring, epidural analgesia, assisted vaginal delivery, cesarean section, hemorrhage, and infection.

The safety of home births is under debate. American, Australian and New Zealand Colleges of Obstetricians and Gynecologists oppose home births while the United Kingdom’s Royal College of Obstetrics and Gynecology and the Royal College of Midwives are supportive, as are midwife organizations in Canada, Australia and New Zealand. Canada’s Society of Obstetricians and Gynecologists has encouraged further research into the safety of home birth, and this study addresses that directive.

“Women planning birth at home experienced reduced risk for all obstetric interventions measured, and similar or reduced risk for adverse maternal outcomes,” writes Dr. Patricia Janssen from the University of British Columbia and coauthors. Newborns born after planned home births were at similar or reduced risk of death, although the likelihood of admission to hospital was higher.

Factors in the home environment that decrease risks are not well-understood and could be due to sample bias. “We do not underestimate the degree of self-selection that takes place in a population of women choosing home birth. This self-selection may be an important component of risk management for home birth.” They write that the eligibility screening by registered midwives safely supports a policy
of choice in birth setting.

“Our population rate of less than 1 perinatal death per 1000 births may serve as a benchmark to other jurisdictions as they evaluate their home birth programs,” the authors conclude (.pdf).

Terrific study. Designed for comparison and peer review.

Nowhere near as political as some author [me] tried to make it with the headline.

A father managed to deliver his baby son after watching DIY baby delivery video clips on YouTube.

Feeling nervous about the imminent birth of his child Marc Stephens had a look at childbirth videos on his home computer.

Four hours later his wife, Jo, went into labour three weeks earlier than expected and, as paramedics rushed to help, Stephens was able to put his new-found knowledge into action and helped deliver 5lb 5oz Gabriele.

Stephens, 28, a naval engineer, told yesterday how he had already learned how to play the guitar and solve the Rubik’s Cube puzzle from YouTube videos. So it didn’t seem too much of a leap for him to check out the whys and wherefores of childbirth.

He said: “I spent about half a hour on Google and watched a couple of videos on YouTube…After he finished looking at the sites at about 10.30pm the couple went to bed, only to wake up at 2am with Jo, 28, in labour…

The baby was delivered safely and both mother and child are doing well. Jo, who has three other children, said: “I was quite relaxed. I have to say, out of all my four labours, that was the one I enjoyed the most. Marc is one of those people who can put his hand to anything.”

Har!