Home birth
Standard practices, licensing requirements and access to emergency hospital care differ between regions making it difficult to compare studies across national borders.
[2][3] Higher maternal and infant mortality rates are associated with the inability to offer timely assistance to mothers with emergency procedures in case of complications during labour, as well as with widely varying licensing and training standards for birth attendants between different states and countries.
A special term evolved in the English language around 1300 to name women who made assistance in childbirth their vocation – midwife, literally meaning "with woman".
The other five additional states which are Idaho, Pennsylvania, Utah, Washington, and Wisconsin, they all had an increase of home births with a percent of 1.50 and above.
When it comes to the Southeastern states which are Texas, North Carolina, Connecticut, Delaware, the District of Columbia, Illinois, Massachusetts, Nebraska, New Jersey, Rhode Island, South Dakota, and West Virginia, they all experienced a lower percentage of home births with only a percentage of 0.50 percent.
[13] In the Northern Territory of Australia, the prescribed steps advocated by the government is that, in rural areas, a woman at 37 weeks gestation must leave "country" and fly to the nearest city.
[17]: 8 In a study published in the Journal of Midwifery and Women's Health, women were asked why they chose a home birth; the top five reasons given were safety, avoidance of unnecessary medical interventions common in hospital births, previous negative hospital experiences, more control, and a comfortable and familiar environment.
[16] One study found that women experience pain inherent in birth differently, and less negatively, in a home setting.
[19] 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.
[26] One doctor described birth in a working-class home in the 1920s: You find a bed that has been slept on by the husband, wife and one or two children; it has frequently been soaked with urine, the sheets are dirty, and the patient's garments are soiled, she has not had a bath.
A movement termed 'pushing for midwives' intensified during the 1990s and early 2000s in the United States, when the public organized to request legislation that would formally legalize midwifery a consumable service.
Hence, the actual rate of home birth in the United States remained low (0.65%) over the twenty years prior to 2007.
The study concluded that the risk of perinatal or neonatal mortality was not different when birth was intended at home or in hospital.
[38] The Journal of Medical Ethics review additionally found that several studies concluded that home births had a higher risk of failing Apgar scores in newborns, as well as a delay in diagnosing hypoxia, acidosis and asphyxia.
If IPPM is higher, this is likely to be in the group of women in whom intrapartum complications develop and who require transfer into the obstetric unit.
[40] In North America, a 2005 study found that about 12 percent of women intending to give birth at home needed to be transferred to the hospital for reasons such as a difficult labor or pain relief.
[43] In 2009 a study of 500,000 low-risk planned home and hospital births in the Netherlands, where midwives have a strong licensing requirement, was reported in the British Journal of Obstetrics and Gynaecology.
The study concluded that for low-risk women there was no increase in perinatal mortality, provided that the midwives were well-trained and there was easy and quick access to hospitals.
The survey excluded congenital anomaly-related deaths, as well as births where the mother was transferred to a hospital prior to beginning labor.
[42] In October 2013 the largest study of this kind was published in the American Journal of Obstetrics and Gynecology and included data on more than 13 million births in the United States, assessing deliveries by physicians and midwives in and out of the hospital from 2007 to 2010.
Given the study's findings, Dr. Amos Grunebaum, professor of clinical obstetrics and gynecology at Weill Cornell Medical College and lead author of the study, stated that the magnitude of risk associated with home delivery is so alarming that necessitates the need for the parents-to-be to know the risk factors.
[...] We emphasize that the increased risks of poor outcomes from the setting of home birth, regardless of attendant, are virtually impossible to solve by transport.
[50] Randomized controlled trials are the "gold standard" of research methodology with respect to applying findings to populations; however, such a study design is not feasible or ethical for location of birth.
Quality studies, therefore, need to take steps in their design to mitigate these problems in order to produce meaningful results.
[51] Modern scientific inquiry into home birth takes place in the fields of anthropology, epistemology, ethnology, history, jurisprudence, medicine, midwifery, public health, sociology, and women's studies.
[57] While a woman in developed countries may choose to deliver her child at home, in a birthing center, or at hospital, health coverage and legal issues influence available options.
There are no current plans to extend Medicare and PBS funding to home birth services in Australia.
[60] In March 2016, the Coroners Court of Victoria found against midwife Gaye Demanuel in the case of the death of Caroline Lovell.
The Provinces of Ontario, British Columbia, Saskatchewan, Manitoba, Alberta, and Quebec currently cover home birth services.
[65] The support of the various Health Authorities of the National Health Service may vary, but in general the NHS will cover home births – the Parliamentary Under-Secretary of State for Health, Lord Hunt of King's Heath has stated that "As I understand it, although the NHS has a legal duty to provide a maternity service, there is not a similar legal duty to provide a home birth service to every woman who requests one.
