Recent Home Birth Evidence: Publications, Politics and Social Justice

Background: A number of new home birth studies have been published internationally in the last couple of years.

Methods: We evaluated six new published home birth studies from Great Britain, the Netherlands, Sweden, Australia and two from Canada (provinces of Ontario and British Columbia). Through interaction with the authors, we explored the history behind the publication of each new study. We evaluated the place and importance of each of these new studies with regard to understanding perinatal safety. Levels of medical intervention across studies were evaluated with particular focus on Caesarean section rates for low risk women. Prematurity rates were also examined.

Results: A general pattern to publication emerged -- the highest profile journals turned down studies with results suggesting perinatal safety and accepted them if the paper framed the study as suggesting a problem with perinatal safety. Rates of prematurity tended to be lower in these midwife-followed populations compared to those in low-risk populations not accessing midwives. Considerably lower Caesarean section rates are found across these studies compared to low risk women choosing hospital births with standard obstetrical care.

Conclusions: These new studies make a significant contribution to the weight of evidence supporting the safety of planned home birth with midwives. They also contribute to further concern about unduly high levels of prematurity and Caesarean section in low-risk women receiving standard obstetrical care.