Home versus hospital birth

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Evidence-Based Midwifery

Background:

• Observational studies suggest planned home birth is safe and associated with fewer interventions compared to planned hospital birth.
• This contrasts with limited evidence from randomized trials regarding maternal and neonatal outcomes.

Purpose of the Study:

• To evaluate the effects of planned home birth versus planned hospital birth on intervention rates, complications, and morbidity.
• To synthesize findings from randomized controlled trials (RCTs) comparing planned home birth with planned hospital birth.

Main Methods:

• Searched Cochrane Pregnancy and Childbirth Group trials register and Cochrane Controlled Trials Register up to September 1999.
• Included controlled trials comparing planned hospital birth with planned home birth for selected low-risk women attended by experienced practitioners with hospital backup.
• Assessed trial quality, extracted data, and contacted study authors for additional information.

Main Results:

• Only one small trial with 11 women met the inclusion criteria.
• The included trial was of reasonable quality but lacked sufficient statistical power to draw definitive conclusions.
• Data on interventions, complications, and morbidity were limited due to the small sample size.

Conclusions:

• There is currently insufficient robust evidence from randomized trials to favor either planned home birth or planned hospital birth for low-risk pregnant women.
• Further high-quality randomized controlled trials are necessary to provide conclusive evidence on the safety and outcomes of planned home birth versus hospital birth.