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Updated: Jun 3, 2025

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Insights from a publicly funded homebirth program.

Sheryl Sidery1, Andrew Bisits2, Virginia Spear2

  • 1School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Australia; Royal Hospital for Women, Sydney, New South Wales, Australia.

Women and Birth : Journal of the Australian College of Midwives
|January 8, 2025
PubMed
Summary

Publicly funded homebirth services in Australia offer favorable outcomes for low-risk pregnancies, including higher rates of physiological birth and fewer interventions. This study highlights the benefits of planned homebirths compared to hospital births for maternal and infant health.

Keywords:
HomebirthMentorshipMidwiferyMidwifery continuity of carePlace of birth

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Area of Science:

  • Obstetrics and Gynecology
  • Public Health
  • Midwifery

Background:

  • High consumer demand for homebirth in Australia contrasts with limited access due to costs and few publicly funded models.
  • Homebirth with a qualified, health-system-linked midwife is a safe option for low-risk pregnancies.

Purpose of the Study:

  • To describe the implementation of a publicly funded homebirth service with an employed mentor.
  • To compare outcomes of homebirths with hospital births within the same Midwifery Group Practice (MGP).

Main Methods:

  • Retrospective comparative cohort study using electronic perinatal data (July 2018 - October 2021).
  • Matched cohort of women receiving MGP care, comparing planned homebirths to hospital births.
  • Matching criteria included parity, age, BMI, spontaneous labor, and gestation (37-42 weeks).

Main Results:

  • Women planning homebirths had significantly higher rates of physiological birth (p<0.001) and intact perineums (p<0.0001).
  • Homebirth group experienced significantly fewer postpartum hemorrhages (p<0.0001) and assisted/cesarean births after transfer (p<0.0001).
  • No significant differences were observed in postpartum hemorrhage rates or Apgar scores <7 at 5 minutes between groups.

Conclusions:

  • Publicly funded homebirth services, as implemented, demonstrate favorable outcomes compared to hospital births for low-risk pregnancies.
  • The role of an employed mentor is crucial for the sustainability of publicly funded homebirth programs.
  • Further research is recommended to evaluate the mentor's impact on program implementation and sustainability.