As a family physician who has provided obstetric services in rural British Columbia for over 20 years, I am upset by the implied safety attached to home births.1 Statistically significant or not, in the study group involving 862 home births there were 3 times as many perinatal deaths compared with the cohort group involving 1314 in-hospital births. As well, 5 infants in the study group required prolonged ventilatory support versus none in the cohort group, and the only 2 cases of hemorrhagic shock occurred in the study group.
If, as the authors state, 7 to 8 years of data collection are required to compare perinatal death rates accurately, why did they then feel compelled to state that “there are no indications of increased risk associated with planned home births attended by regulated midwives”? The lay press has concluded that home births have been shown to be as safe as, if not safer than, in-hospital births. If we look at serious complications, this is clearly not the case.
If nothing else, the study should raise legitimate concerns regarding the safety of home births. Unfortunately, these concerns have not been conveyed to expectant mothers trying to make an informed choice.
Jim Petzold Family Physician Gibsons, BC
Reference
- 1.Janssen PA, Lee SK, Ryan EM, Etches DJ, Farquharson DF, Peacock D, et al. Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia. CMAJ 2002;166(3):315-23. [PMC free article] [PubMed]