Home Birth: Gone Away, Gone Astray, and Here To Stay


  • Marc J.N.C. Keirse MD, DPhil, DPH, FRCOG, FRANZCOG

    1. Marc Keirse is Professor of Obstetrics and Gynaecology at Flinders University, Adelaide, South Australia, Australia.
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    Wax JR, Lucas FL, Lamont M, Pinette MG, Cartin A, Blackstone J. Maternal and newborn outcomes in planned home birth vs planned hospital births: A meta-analysis. Am J Obstet Gynecol 2010;203:243.e1–243.e8.de Jonge A, van der Goes BY, Ravelli ACJ, Amelink-Verburg MP, Mol BW, Nijhuis JG, Bennebroek Gravenhorst J, Buitendijk SE. Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births. BJOG 2009;116:1177–1184.

Address correspondence to Marc J.N.C. Keirse, MD, DPhil, DPH, FRCOG, FRANZCOG, Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders University, Flinders Medical Centre, Bedford Park, SA 5042, Australia.


Abstract:  Home birth has attracted a great deal of attention of late, culminating in a meta-analysis to assess its risks for mother and baby. Mothers were estimated to be 2.6 times more likely to die and babies 3 times more likely to die from a planned home birth than from a planned hospital birth. The actual data on which these estimates were based demonstrate that meta-analysis can be developed into an art that suits whatever purpose its authors hope to achieve. Combining studies of home versus hospital, without differentiating what is inside them, where they are, and what is around them, is akin to producing a fruit salad with potatoes, pineapples, and celery. (BIRTH 37:4 December 2010)