Outcomes of Planned Home Birth: An Integrative Review

Authors

  • Judith T. Fullerton CNM, PhD,

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    • Judith Fullerton, CNM, PhD, FACNM, is the Senior Technical Advisor, Monitoring & Evaluation, Project Concern International, and Professor (retired), University of California, San Diego, School of Medicine, and University of Texas, El Paso, College of Health Sciences.

  • Ana M. Navarro PhD,

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    • Ana Navarro, PhD, is an Associate Professor in the Department of Family and Preventive Medicine, University of California, San Diego.

  • Susan H. Young MA

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    • Susan Young, MA, is the Department Chair, Social Studies, Vista Heights Middle School, Moreno Valley, CA. She served as research assistant for this study.


Address correspondence to Judith T. Fullerton, CNM, PhD, 7717 Canyon Point Lane, San Diego, CA 92126-2049. E-mail: jfullerton@san.rr.com

Abstract

Current evidence indicates the critical importance of several factors that contribute to improved perinatal outcomes: a facilitating environment at the place of birth, skilled birth attendance, and the continuum of perinatal care for women and newborns. This level of care is often referred to as “first-level” care, and is most readily provided in birthing centers and primary level health facilities. However, there is a body of evidence that has been compiled over the past several decades that addresses the safety of planned home birth, under circumstances that emulate these elements of “first-level” care. These studies demonstrate a remarkable consistency in the generally favorable results of maternal and neonatal outcomes, both over time and among diverse population groups. These outcomes are also favorable when viewed in comparison to various reference groups (birth center births, planned hospital births, and vital statistics). These data should influence policy in support of planned home birth, including policy that endorses building or sustaining a home birth infrastructure in parallel to the efforts to build capacity for facility-based birth. Such public policy would also be in keeping with the fundamental right of women to have choice in childbirth, particularly when options are equally good.

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