In women in the study who had a priori a low risk of complications and who had given birth at least once before, 1 in 1,000 births at home suffered serious complications, such as admission to intensive care unit and required a large blood transfusion. The rate of the same complications in planned hospital births was 2.3 per 1000 births.

Home births also had a lower risk of less serious complications, such as bleeding after childbirth, or the need to remove the placenta manually. The rate of bleeding or postpartum hemorrhage, was 19.6 in 1000 for home birth, compared to 37.6 in 1000 for the birth in the hospital.

The safety of giving birth at home to hospital is controversial. While his detractors concerned that in an emergency, the time required to transport the woman or the baby home from the hospital could exacerbate the problem, his supporters question whether it is prudent to recommend routinely deliver in a hospital for women low risk, which could be subject to unnecessary medical interventions with potentially harmful effects.

This study compares the rate of serious complications of labor at home and in the hospital in a large group of low-risk women in the Netherlands, a country that boasts one of the highest percentages of home births in Western countries.

The researchers identified more than 146 000 women with low-risk pregnancies. Of these women, 92,333 (63 percent) planned to give birth at home, and 54,419 (37 percent) preferred a hospital birth.

The researchers found that the risk of complications was low in both groups and there was no evidence that home birth would lead to an increased risk of serious complications. The only significant difference between the groups was seen only in women who had given birth before.

The results held even when taking into account factors that increase the risk of birth complications, such as maternal age and ethnicity.

Researchers say women who have already had a difficult birth should plan the next in a hospital, although there is no medical indication for it.

These findings are likely to apply only in areas where midwives are well trained to assist women in childbirth at home and where transport services in case of emergency are adequate.

The fact that the study did not find higher rates of serious complications in home births should not lead to complacency, the researchers say. "The appearance of only a serious complication and is too" they conclude.


Photo By Tom Adriaenssen (http://www.flickr.com/photos/inferis/110652572/) [CC-BY-SA-2.0], via Wikimedia Commons