A national study led by researchers at Oregon State University (OSU) has found that planned home births are just as safe as births conducted in accredited birth centers for low-risk pregnancies. The findings, published in the journal Medical Care, challenge longstanding concerns from the medical community regarding the safety of home births.
The study analyzed data from two national registries documenting community births—defined as planned births either at home or in a birth center—across all 50 U.S. states from 2012 to 2019. According to Marit Bovbjerg, an associate professor in the OSU College of Health, low-risk pregnancies typically involve a single baby carried to full term (at least 37 weeks) without major maternal complications such as diabetes or pre-eclampsia. Bovbjerg noted that at least 70% of pregnancies fall into this low-risk category.
The analysis included over 110,000 births and revealed no significant safety differences between home births and those at birth centers. Historically, while medical professionals have raised objections to planned home births, they have generally accepted the safety of birth centers, which provide a more natural and home-like environment compared to hospitals.
“This study is the first to provide evidence that these two birth settings are equally safe,” said Bovbjerg. “Until now, we lacked data comparing outcomes between home and birth center births.”
Bovbjerg and her colleague, Melissa Cheyney, a professor at OSU and a licensed midwife, did not directly compare the safety of community births to hospital births. However, they referenced a 2020 report from the U.S. National Academies of Sciences, Engineering, and Medicine, which supports the notion that planned community births are a safe alternative to hospital births.
“Evidence already existed showing that birth centers were comparable to hospitals for low-risk births,” Bovbjerg stated. “Our study extends this understanding, suggesting that both home and birth center settings are reasonable choices for low-risk birthing individuals.”
The researchers highlighted a growing trend in the U.S., where the rate of home births has increased over the past two decades. Currently, approximately 2% of U.S. births occur in community settings, which offer similar attendants and interventions but differ in practice standards, regulatory guidelines, and integration with health systems.
Notably, the study found that planned home births resulted in a lower rate of transfers to hospitals compared to planned birth center births. This difference may be attributed to concerns about negative experiences in hospitals, including fears of losing continuity of care and potential mistreatment upon arrival.
Cheyney pointed to a national care-experience study indicating that many individuals reported negative interactions in hospital settings, such as being ignored or subjected to invasive procedures without consent. This issue was particularly pronounced among Black and Indigenous individuals who transferred from home births to hospitals.
“If previous hostile transfer experiences contribute to a reluctance to transfer, we need to work on improving the transfer experience,” Cheyney emphasized. “Transfers from community settings are often necessary, and anything that discourages a necessary transfer can lead to harm.”
The research collaboration included experts from the American Association of Birth Centers, Georgia State University, Frontier Nursing University, the University of Denver, and the University of British Columbia.
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