The Safety of Home Birth – New Study of 530,000 Women

A recent study in the Netherlands, a country known for it’s fantastic maternal and infant outcomes, has proven that home birth is safe.  It is the largest study of it’s kind and found that low-risk women planning to give birth at home had as good outcomes as low-risk women birthing in the hospital.

Check it out!

Home births ‘as safe as hospital’

Newborn baby

There have been few comprehensive studies into home births

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

Research from the Netherlands – which has a high rate of home births – found no difference in death rates of either mothers or babies in 530,000 births.

Home births have long been debated amid concerns about their safety.

UK obstetricians welcomed the study – published in the journal BJOG – but said it may not apply universally.

The number of mothers giving birth at home in the UK has been rising since it dipped to a low in 1988. Of all births in England and Wales in 2006, 2.7% took place at home, the most recent figures from the Office for National Statistics showed.

The research was carried out in the Netherlands after figures showed the country had one of the highest rates in Europe of babies dying during or just after birth.


It was suggested that home births could be a factor, as Dutch women are able and encouraged to choose this option. One third do so.

But a comparison of “low-risk” women who planned to give birth at home with those who planned to give birth in hospital with a midwife found no difference in death or serious illness among either baby or mother.

“We found that for low-risk mothers at the start of their labour it is just as safe to deliver at home with a midwife as it is in hospital with a midwife,” said Professor Simone Buitendijk of the TNO Institute for Applied Scientific Research.

“These results should strengthen policies that encourage low-risk women at the onset of labour to choose their own place of birth.”

Hospital transfer

Low-risk women in the study were those who had no known complications – such as a baby in breech or one with a congenital abnormality, or a previous caesarean section.

Nearly a third of women who planned and started their labours at home ended up being transferred as complications arose – including for instance an abnormal fetal heart rate, or if the mother required more effective pain relief in the form of an epidural.

The NHS is simply not set up to meet the potential demand for home births
Louise Silverton
Royal College of Midwives

But even when she needed to be transferred to the care of a doctor in a hospital, the risk to her or her baby was no higher than if she had started out her labour under the care of a midwife in hospital.

The researchers noted the importance of both highly-trained midwives who knew when to refer a home birth to hospital as well as rapid transportation.

While stressing the study was the most comprehensive yet into the safety of home births, they also acknowledged some caveats.

The group who chose to give birth in hospital rather than at home were more likely to be first-time mothers or of an ethnic minority background – the risk of complications is higher in both these groups.

The study did not compare the relative safety of home births against low-risk women who opted for doctor rather than midwife-led care. This is to be the subject of a future investigation.

Home option

But Professor Buitendijk said the study did have relevance for other countries like the UK with a highly developed health infrastructure and well-trained midwives.

Women need to be counselled on the unexpected emergencies which can arise during labour and can only be managed in a maternity hospital

In the UK, the government has pledged to give all women the option of a home birth by the end of this year. At present just 2.7% of births in England and Wales take place at home, but there are considerable regional variations.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said, the study was “a major step forward in showing that home is as safe as hospital, for low risk women giving birth when support services are in place.

“However, to begin providing more home births there has to be a seismic shift in the way maternity services are organised. The NHS is simply not set up to meet the potential demand for home births, because we are still in a culture where the vast majority of births are in hospital.

“There also has to be a major increase in the number of midwives because they are the people who will be in the homes delivering the babies.”

Mary Newburn, of the National Childbirth Trust, said: “This makes a significant contribution to the growing body of reassuring evidence that suggests offering women a choice of place of birth is entirely appropriate.”

The Royal College of Obstetricians and Gynaecologists (RCOG) said it supported home births “in cases of low-risk pregnancies provided the appropriate infrastructures and resources are present to support such a system.

But it added: “Women need to be counselled on the unexpected emergencies – such as cord prolapse, fetal heart rate abnormalities, undiagnosed breech, prolonged labour and postpartum haemorrhage – which can arise during labour and can only be managed in a maternity hospital.

“Such emergencies would always require the transfer of women by ambulance to the hospital as extra medical support is only present in hospital settings and would not be available to them when they deliver at home.”

The Department of Health said that giving more mothers-to-be the opportunity to choose to give birth at home was one of its priority targets for 2009/10.

A spokesman said: “All Strategic Health Authorities (SHAs) have set out plans for implementing Maternity Matters to provide high-quality, safe maternity care for women and their babies.”

I’m Certified!

I’m certified!!  (or certifiable, depending on how you look at it 😉 )

My certification through CAPPAt came through yesterday and I’m so excited!  It’s nice to have the formality out of the way.  Basking in the glow…

STUDY – Vitamin D deficiency linked to primary C-section rate

image-3931619-35797336-2-websmall_0_dd0f5a04af6e73346ed777299ec88556_1A small study found that twice as many women (28%) who were vitamin D deficient at the time of giving birth had a Caesarean delivery compared with those with normal levels (14%).

Read the article from Medscape

Karen Robinson, a local Certified Professional Midwife, said the following about the benefits of vitamin D during pregnancy:

Vitamin D is getting a lot of scrutiny lately and is being found to be a superstar vitamin that we haven’t paid enough attention to.

Vitamin D supplementation can help increase immunity and decrease the impact and frequency of colds and common viruses.

Its role is also being looked at closely in the implantation of the placenta, how well the placenta functions, and therefore prevention of pre-eclampsia.

In our world of indoor jobs and layers of sunscreen when we do go outside, it’s easy to see how the majority of us may be deficient in Vitamin D.

The best places to get Vitamin D include a bit of sun exposure every week (so that the body can manufacture its own Vitamin D), fatty fish (salmon, mackerel, tuna, etc), fish oil (especially cod liver oil) and beef liver.

So, one thing doulas can do for their clients is to encourage good diet (lots of fresh fruits and vegetables, clean meats and plenty of fats) and suggest they consider supplementation of Calcium/Magnesium, Folic Acid, and Vitamin D.

You know you’re a doula when…

I’ve started a fun little game on my doula group where we come up with the funniest “You know you’re a doula when…” quotes.  I’ll try and keep adding them as they come up!

You know you’re a doula when

You misread “Pasta Primavera” as “pasta primapara.”

You carry more supplies and luggage to a birth than you do when you go on vacation.

You watch births on TV shows and can’t help but talk to the television the entire time. “See, you shoulda had a doula!” “Stop counting to ten with each push.  She knows how to push!” “WHY are they doing THAT??”

While watching “A Baby’s Story” with your ten year old son, he rolls his eyes and says “not another epidural!”

You watch a professional basketball game on TV, see all those shaved heads as caputs, and speculate as to their presentation at birth.

You spend hours each day on the computer, yet when someone mentions they are in an “LDR”, you first think of “Labor and Delivery Room”. Not a long distance relationship.

You rejoice at the following – swearing, vomiting, pooping on the bed, nausea, gas, belching – let’s see did I leave anything out? and think “Cool! We’re getting close!”

You can see a woman vomit, urinate, defecate, spray amniotic fluid while in labor, or have a cesarean without a second thought.

You check on your kids in the middle of the night and your three year old mumbles “Did her water break?”

My daughter pumping

My daughter pumping

When your daughter’s boyfriend knows what effacement is.

Your kids tell their friends that Mommy had another baby and was up all night.

Your children think all pregnant ladies know you.

Your children know more about birth than most women who have given birth to 3 babies.

Your seven-year-old son refuses to marry anyone who won’t birth at home.

Your son is doing a great job learning to read but cant figure out why the teacher keeps talking about contractions.

Your 16 year old takes a child development class in high school and knows more that the teacher about birth, breastfeeding and parenting.

You unconsciously think “Labor Pool” is a water-filled tub for a woman to lay in while having her baby, not a group of workers.

Your child wakes you up in the middle of the night and you mumble, “How far apart are they?”

You live for the times someone says, “A doula? What’s that?”

You and your family think it’s totally normal to discuss 1st, 2nd, 3rd & 4th degree episiotomies over dinner… you explain what a placenta looked like over spaghetti… heck you even discuss placental abruptions and calcifications over a roast beef.

You’ve been in bed with more women than you care to admit in mixed company.

You’ve touched more breasts than you care to admit in mixed company.

You have more pictures and videos containing naked women in your home than the porno shop downtown.

You pack and repack your birth bag 3 times, check the on off switch on your pager/cell phone 5 times and go to bed with your clothes on… on a hunch…and you get called three hours later.

Your client snaps at you and you think: “Oh good, she’s not smiling anymore!”

When your spouse knows to ask three questions: Are you in labor? If no, Is this an emergency? Would you like her to call you back later or do you want her cell phone number?

You hubby asked was it a girl or a boy and rolls over and goes back to sleep.

The guy at the photo shop passes out while developing your film.

Although you do poorly in math, you can instantly calculate how much more weight the birth ball can hold.

Your client is nearing her due date and you become fascinated by what she sees when she wipes and how soft her bowel movements are.

Your teenagers answer the phone and start by saying “how far apart are the contractions?”

You see a metal mixing bowl in a store and think “placenta”.

Or…you see a metal mixing bowl and think “vomit”.

When while everyone else in the room is yelling and counting, “hold your breath, chin down, no noise, 1, 2, 3, pushhhhhhhhh harder harder.” You are the only one in the room whispering in the moms ear “listen to your body, you are doing such a great job, look down, push your baby out, just like that, You are sooooooooo awesome!”

You’re so exhausted you could weep, you haven’t gone pee for 9 hours even though your bladder’s bursting, you’ve just wiped poo from someone’s backside, you have flecks of blood and vomit on your shoes, but there is still no place in the world you’d rather be.

You know you’re a doula when PROM doesn’t make you think of high school. (me)

You know your a doula when your 5 year old tells another child “No your baby brother isn’t growing in your mommy’s tummy. He is in her UTERUS. Mommies don’t eat the babies!” (Desirre)

You know you’re a doula when you overhear your husband explaining to another man how to watch a woman’s behavior for dilation during labor.  (Nicole Yingling)

You know you’re a Doula When, your 5 year old Son wants to be an OB cause what mommy does is so cool, but he’s convinced that Doulas have to be girls. Even though I’ve NEVER ever told him Doulas have to be girls.  (Sara)

Site of the Week!!

I’m proud to announce that this website has earned Denver Color’s “Site of the Week” for the first week in January!  I didn’t even know it until I googled myself (which is quite entertaining!).  It’s just nice that they wrote up a fabulous little blurb about doulas.

Check it out…

SITE OF THE WEEK – FOR 2009-01-01

Birthing Body – Gentle Birth Services

To bring in the New Year, I thought I would declare a doula web site as the Site of the Week for New Year’s day 2009.

A doula is a person trained in the birthing process who works closely with a mother and her healthcare provider to help assure a happy, healthy birth. The doula works for the mother and serves as the mother’s advocate. The ideal held by the doula community is that the mother, in consultation with a primary care provider, makes all of the important decisions. Any doula worth her salt will support the choice of birth location: hospital, birthing centers or home.

Likewise, doulas are trained to be supportive of the OB-GYNs when a c-section is necessary. The point of a supporting role is to help people make the best decision. The data seems to show that the involvement of a doula dramatically decreases the number of c-sections without increasing the risk to mother or child. The goal of the doula is to empower the mother with information and support in making the best decision.

Quite frankly, I believe that this model being worked out in the doula community would be a good model for the health care industry at large. I have a great deal of respect for the highly trained doctors and nurses in the health care system. Unfortunately, the industrial nature of modern health care seems to have blunted its humanity. I think it would be wonderful if we all had doula-like advocates to help us interface with the health care system.

Soap box aside, the site of the week is Birthing Body by Amy Swagman who offers doula services in the Denver area. The site has a quick run down of Amy’s qualifications and services.

A quick word of warning. If you use Amy’s doula services, she is likely to paint a henna picture on your belly.

Babywearing – Sleepy Baby Wrap

Sleepy Wrap

Sleepy Wrap

…go to Sleep Wrap Website

Here’s a great wrap made of really cute fabric!

Why it’s great:

  • One size fits all (babies and mom and dad)
  • Super comfortable, rests on both shoulders
  • Fabric is comfy, like a t-shirt with the perfect amount of stretch
  • Easy to clean (ALWAYS important!!)
  • Will carry newborn through toddler (and yes, toddlers like slings too!)
  • Cute colors

Instruction Videos:

How to tie, Front Carry (Toddler)

Forward-Facing Hold

Rucksack Back Carry

Where to buy in Denver:

Living Earth Babies in Boulder

Diaper Dash Inc. in Broomfield

Kanga Kare in Littleton

Babywearing – Nojo Original Baby Sling

Nojo Original Baby Sling

Nojo Original Baby Sling

…go to Nojo Website

Here is your standard padded ring sling, endorsed by the renowned Dr. Sears, founder of Attachment Parenting.

Why it’s great:

  • Easy to put on
  • Easy to breastfeed in
  • Padded rails make baby comfortable
  • Can do cradle carry, side carry, facing out carry, or facing in carry
  • Since it’s easy to get baby in they don’t fuss when you put them in

What it lacks:

  • Being padded, it’s hot in the summer
  • Limited positions for baby to be in
  • Limited colors (just the blue plaid as shown and a gray color)
  • Tough on your back when your baby is big since it only rests on one shoulder
  • Rails make the shoulder kind of bulky

Instruction Videos:

Ring Sling Demo