Planning for one can reduce C-section rate
TORONTO, July 13, 2016 – A new guideline released by the Association of Ontario Midwives today confirms the safety of home birth and recommends it should be considered by all with low-risk pregnancies.
In developing the guideline, a panel reviewed Canadian evidence and found that midwifery clients who plan a home birth often have fewer complications than those who plan a hospital birth. Based on four research studies that examined records of more than 45, 000 births in Ontario and British Columbia, the guideline’s review found that babies’ health outcomes are the same, whether their birth was planned at home or in a hospital. In these clinical studies evaluated by the panel, planning home birth was also found to reduce interventions like C-section by up to 30% and the need for drugs to speed up labour by as much as 40%.
“We’ve always known that home birth in Ontario is safe,” says midwife Liz Darling, PhD, chair of the Expert Advisory Panel tasked with writing the guideline. “This new guideline provides midwives with an additional way of talking to their clients about the safety of home birth, using rigorous research from right here in Canada and in Ontario.”
Two of the four Canadian studies examining home birth were led by Eileen Hutton, PhD, an internationally recognized midwifery researcher and director of the Midwifery Education Program at McMaster University. These studies are the largest to date in Canada, examining provincial records of all Ontario home births with midwives from 2003 to 2009. The other two studies were conducted by Patricia Janssen, PhD at the University of British Columbia.
Canadian findings are consistent with international research on home birth out of the U.K., New Zealand, the Netherlands and Norway, which have similar midwifery services available. However, they have the advantage of being representative of the population and health-care system in Canada.
In the April 2016 editorial from the Journal of Obstetrics and Gynaecology Canada, Hutton noted: “The message for Canadian physicians, midwives, families, and policy makers is this: in provinces in which midwifery is regulated, and home birth is a part of that regulation, home birth is well-integrated into the health care system.” She adds that “this has resulted in safe outcomes for babies whose birth was planned at home and lower rates of obstetrical intervention.”
In addition, BORN Ontario recently released its evaluation of the Ottawa and Toronto birth centres and found birth outcomes (i.e., safety and decreased need for intervention) in these locations were consistent with home birth outcomes in Ontario. Together, the new guideline and the birth centre report provide families with more easily accessible evidence to inform their decisions about where to give birth and show that out-of-hospital birth is a safe option.
Currently, midwives are the only health-care providers in Ontario who are trained to attend low-risk births at home and other out-of-hospital settings. Choice of birthplace is fundamental to Ontario midwives’ model of care.