Is it safe to have my baby with a midwife?

Safety is of importance to us…We think that midwives are skilled at blending both nurturing supportive care and appropriate technology to insure safe and normal birth. Plenty of research supports this.

Studies about planned home birth and birth center birth in the medical literature uniformly report outcomes equivalent or superior to those of comparable women giving birth in the hospital.

In 2005, the British Medical Journal published a study of 5418 planned home births which once again concluded that this is a safe option for low risk (healthy) women. The study confirmed that home birth with midwives was associated with lower rates of medical intervention, while maintaining similar intrapartum and neonatal mortality as that of hospital birth for low-risk women.

Fullerton and Severino report in a 1992 study published in the Journal of Nurse Midwifery that:

“[Low risk] women in hospital were more likely to receive an interventive style of labor and birth management. Neonatal outcomes were similar, although the incidence of sustained fetal distress, prolapsed cord, and difficulty in establishing respirations were significantly greater in the hospital sample. Hospital care did not offer any advantage for low risk women, and it was associated with increased intervention.”1

There are many studies exploring this issue of safety and homebirth. One of the largest, involving over 24,000 births, compared the safety of planned homebirth with planned hospital birth for low-risk women.2 This study compared several outcomes, the main ones being infant and maternal mortality. There was no difference between the two groups in either infant or maternal mortality. However, “Approximately twice as many babies in the hospital group as in the home birth group had low Apgar scores.” Apgar scores are a measure of a baby’s well being in the first few minutes of life. Episiotomies (an incision done to enlarge the vaginal opening at the time of birth) are an intervention that is often done in hospitals. This is true, despite the fact that they frequently lead to more severe lacerations and that they do not improve outcomes. In Olsen’s study, there were 50% more perineal lacerations among the women who delivered in hospitals.

One of the main reasons for homebirth’s good track record is that midwives have the flexibility to be patient and wait for the woman to give birth at her own pace. Midwives are not held to tight time constraints, and consequently are not tempted to rush the process of birth. This simple act of waiting patiently for the birth to unfold prevents the need for many interventions that can themselves cause the baby or mom to develop “complications.” Midwives combine the art of waiting and watching with careful monitoring of the mom and baby to ensure that the birth progresses normally.