Home births are three times more likely to lead to the loss of a baby, warns new research.
A study of almost 250,000 women found out of every 1,000 infants born in non-hospital settings 15 died – compared to five in hospitals.
The findings suggests the risk is more than twice as high as that estimated by the NHS.
The study comes as a growing number of women have opted to use more personal midwives to help them give birth at home.
In the age of #MeToo, women across the world are making moves to protect their agency over their bodies. That includes childbirth.
But scientists at Ben-Gurion University of the Negev (BGU) in Israel say the trend is increasing the risk of complications – leading to ‘perinatal mortality.’
This was defined as the death of a newborn at delivery or within the first six weeks of life.
The finding presented at a Society for Maternal-Foetal Medicine meeting in Las Vegas was based on the births of 3,580 women who had babies out of hospital in Israel between 1991 and 2014.
These were compared to some 240,000 mothers who gave birth at Soroka University Medical Center in Beersheba, which is affiliated to BGU, during the same period.
Lead author Professor Eyal Sheiner said “Approximately 15 out of every 1,000 babies born in non-hospital settings are at risk of death, compared to only five out of every1,000 babies born in hospitals.”
The former group included both planned and unplanned home births, along with accidental ones.
When taking into account other factors including the mother’s health, age, health habits such as smoking and ethnic background, the occurrence of a death remained 2.6 times higher than those who had their baby in hospital.
Prof Sheiner said: “This study matches the findings of larger studies conducted in the United States and confirmed our hypothesis that childbirth in non-hospital settings is far more dangerous than in hospitals.
“There is no question that a hospital provides the most secure environment to give birth, both for mothers and their babies.
“Even with the advances of modern medicine, childbirth is still traumatic for both the mother and child and it is critical to prepared for any scenario.”
He added: “Perhaps once-upon-a-time the difference between home and hospital for giving birth was less important because of our ancestors’ limited understanding of medicine, but today there is a quantum difference.
“Tracking both the mothers’ and babies’ progress, heart rate, blood pressure and overall health in real time and immediate access to operating theaters and emergency treatment in the event of a problem gives the medical team the best chance to navigate the difficult situation effectively.”
Globally, some 2.5 million children died in their first month of life in 2017, according to UNICEF data published in March 2018, most of them in the first week of life.
About a million babies dying on their first day and close to a million dying within the next six days.
In the US, in particular, the controversial ‘free birth movement’ is growing in popularity.
It believes medical professionals and even midwives are ‘oppressive’ forces in the very personal process of childbirth.
A growing number of women have been choosing to give birth with the assistance of a midwife or doula to make the experience more personal.
A blog of personal stories on the Free Birth Society’s website features nearly 40 tales of women who gave birth without medical assistance.
Women sharing their experiences there talk about giving birth by ‘intuition,’ in nature and ‘in power.’
Many of them had given birth previously, in more standard hospital settings and found the experience deeply traumatic.
They are among a contingent of women choosing unassisted ‘free births’ – and their numbers seem, anecdotally, to be growing.
The phenomenon isn’t isolated to the US, either.
A 2016 study asked women who had given birth unassisted in the US, UK, Sweden, Finland, Australia and Finland why they chose that method.
Some felt that the risk of unnecessary medical treatments or interventions was more dangerous to them and their babies than were the risks of serious complications in a free birth.
Many simply felt that they wouldn’t have any control over their delivery if it occurred in a hospital.
The NHS says in England and Wales, just over 1 in 50 pregnant women give birth at home.
It adds: “Giving birth is generally safe wherever you choose to have your baby.
“But for women having their first baby, home birth slightly increases the risk of serious problems for the baby – including death or issues that might affect the baby’s quality of life – from 5 in 1,000 for a hospital birth to 9 in 1,000 for a home birth.
“For women having their second or subsequent baby, a planned home birth is as safe as having your baby in hospital or a midwife-led unit.”