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Study Shows Having Baby at Home Is Safe

But Pediatrician Says It's Tough to Be Prepared for Emergencies at Home

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Falcao, who is not a nurse, has attended at about 100 home births in and around Silicon Valley. She tells WebMD that it has become more difficult over the past few years to find partner physicians to work with her if the mom ends up needing medical care. She says insurance companies in California have adopted a policy of terminating the malpractice insurance of doctors who back up home-birth midwives.

She estimates that just under a third of her first-time moms will end up giving birth in a hospital due to complications, but the rate is much lower among women who have already had babies.

A total of 12% of the women who planned home births in the newly published study ended up being transferred to hospitals due to complications.

Most Midwife Births in Hospitals

According to CDC figures, the number of births attended by midwives increased steadily between 1975 and 2002, rising from just under 1% in the mid-'70s to 8%.

But the vast majority of these births were attended by nurse midwives in hospitals or birthing centers. There are no good figures on home births in the United States, but in a 2000 report the CDC estimated that the numbers are growing.

The American College of Obstetricians and Gynecologists (ACOG) represents more than 46,000 women's health care physicians. The group opposes home birth.

"Labor and delivery, while a physiologic process, clearly presents potential hazards to both mother and fetus before and after birth," the ACOG position statement on home birth states. "These hazards require standards of safety that are provided in the hospital setting and cannot be matched in the home situation."

Pediatrician Concerned About Home Births

In a 2002 study, Seattle pediatrician Jenny W. Pang, MD, MPH, and colleagues from the Washington School of Public Health reported that babies delivered at home have nearly twice the risk of dying shortly after birth as those born in the hospital. The researchers reviewed more than 7,500 home births and 14,000 hospital births in Washington between 1989 and 1996.

Pang tells WebMD that the risk was still very small, with just 0.33% of babies born at home dying, compared to 0.17% of hospital-born babies. And she says she does not believe the findings reflect a difference in competence between attending physicians and midwives.

"Whether you are talking about a physician, a nurse-midwife, or a [non-nurse] midwife, the thing that matters most is how much experience they have," she says. "My reservations about home births have less to do with who is in charge than they do with location. You can't possibly be set up for all the emergencies that may arise in a home setting."


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