In The Literature: Home Birth: Safe Enough, But Not for the First Baby

Authors

  • Pierre Buekens, MD, MPH, PhD,

    Corresponding author
    • Professor of Epidemiology and Dean at Tulane University, School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
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  • Marc J.N.C. Keirse, MD, DPhil, DPH, FRCOG, FRANZCOG

    1. Professor of Obstetrics and Gynaecology at Flinders University, Adelaide, South Australia, Australia.
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  • COMMENTARY ON: Birthplace in England Collaborative Group. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: The Birthplace in England national prospective cohort study. BMJ 2011;343:d7400.

Address correspondence to Pierre Buekens, MD, MPH, PhD, Dean, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., Ste. 2430, New Orleans, LA 70112, USA.

Abstract

The “Birthplace in England” study compared low-risk pregnancies by planned place of birth at the onset of labor: home, midwifery unit, or obstetric unit. The study showed that childbirth interventions were less frequent in all nonobstetric settings than in obstetric units, confirming what has been noted elsewhere. For parous women, there was no difference in perinatal outcomes by place of birth. For nulliparous women, perinatal outcomes were similar in midwifery and obstetric units, but the frequency of poor outcomes with planned home births was higher. The major strengths of the study are its prospective design and large sample size. The results support providing choices to women, but suggest that women should not be encouraged to give birth at home for their first baby. (BIRTH 39:2 June 2012)

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