“Outcomes of planned home births with certified professional midwives: large prospective study in North America.” Kenneth C Johnson, senior epidemiologist, Betty-Anne Daviss, project manager. BMJ  2005;330:1416 (18 June).  Published online at http://bmj.bmjjournals.com/cgi/content/full/330/7505/1416?ehom

A study published in the June 18 edition of the British Medical Journal found that for low risk women in the United States, planned home births are as safe as hospital births, and accomplished with much less medical intervention, compared with low risk hospital births.  The researchers used prospective data on more than 5000 planned home births in North America attended by Certified Professional Midwives during the year 2000. This study is the largest yet on this subject, according to author Ken Johnson.

The study results belie the consistent claim of U.S. medical professionals and their organizations that “home birth is dangerous,” a belief that is not supported by the weight of scientific evidence. 

“We challenge U.S. physician organizations to acknowledge the findings of this study and others like it, and to actively support legislative and regulatory changes that will promote access to out-of-hospital maternity care provided by professional (independent) midwives, such as Certified Professional Midwives,” said Susan Hodges, President of Citizens for Midwifery, a U.S. grassroots organization.

The researchers analyzed outcomes and medical interventions for planned home births, including transports to hospital care.  According to the British Medical Journal press release, they found:

• Planned home births “had a low mortality rate during labor and delivery, similar to [rates] found in most studies of low risk hospital births in North America.”
• “Rates of medical intervention, such as epidural, forceps and caesarean section, were lower for planned home births than for low risk hospital births.”
• “A high degree of safety and maternal satisfaction were reported, and over 87% of mothers and babies did not require transfer to hospital” care.

These outcomes indicate that, despite many of the midwives in the study not being well-integrated into the healthcare system, appropriate transports were accomplished, and mothers and babies who needed hospital-based medical care received that care.   Imagine the benefit to women and their families if these maternity care providers were welcomed and integrated into the American health care system. In addition, the results suggest that low risk women giving birth in hospitals many be subject to overuse of interventions that are not necessary for good outcomes.

Citizens for Midwifery expects this study to be a wake-up call that refocuses U.S. maternity care on evidence-based practice including access to professional midwives and out-of-hospital birth.

For more information, contact the authors:
Kenneth Johnson, Senior Epidemiologist, Surveillance and Risk Assessment Division, Center for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Canada
Tel: 1 613 957 0339

To arrange an interview, please call Aggie Adamczyk: 1 613 941 8189 (Public Health Agency media contact)

Email: ken_lcdc_johnson@phac-aspc.gc.ca

 
Betty-Anne Daviss, Project Manager, FIGO Safe Motherhood/Newborn Initiative, Housed at The Society of Gynaecologists and Obstetricians of Canada, 780 Echo Drive, Ottowa, Canada
Tel: 1 800 561 2416  OR  1 613 730 4192 Ext. 263
Email: badaviss@sogc.com

 
For more information about the Certified Professional Midwife credential, contact:
Debbie Pulley, Public Education and Advocacy
North American Registry of Midwives
1-888-842-4784
info@narm.org

 
For more information about midwifery education leading to the Certified Professional Midwife credential:
Mary Ann Baul, Executive Director
Midwifery Education Accreditation Council
928-214-0997
info@meacschools.org

For information about Certified Professional Midwives in the U.S.:

National Association of Certified Professional Midwives
http://www.nacpm.net 

Mary Lawlor, President
802-387-4678

lawcing@sover.net

For more information about midwifery in North America:
Midwives Alliance of North America
888-923-MANA (6262)
E-mail info@mana.org