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27 September 2012
Home birth a human right, concludes review

An extensive new review based on results from numerous birthing studies has concluded that all countries should consider establishing organized home birth services. The report, appearing as a Cochrane Review, was prepared by medicos from the University of Copenhagen.

The review notes that observational studies in different settings suggest that planned home birth can be as safe as planned hospital birth - with less intervention and fewer complications.

"If home birth is going be an attractive and safe option for most pregnant women, it has to be an integrated part of the health care system," report author Ole Olsen says. "In several Danish regions the home birth service has been very well organized for several years. This is not the case everywhere in the world."

Olsen's report concludes that there is no strong evidence to favor either planned hospital birth or planned home birth for low-risk pregnant women. She points out, however, that there are 20-60 percent fewer interventions in homebirth; and 10-30 percent fewer complications (for example post partum bleeding and severe perineal tears).

"At home the temptation to make unnecessary interventions is reduced. The woman avoids for example routine electronic monitoring that may easily lead to further interventions in birth," explained report co-author Jette Aaroe Clausen.

The report also notes that there is growing international concern over interventions which may lead to iatrogenic effects (unintended consequences of the intervention). Routine electronic monitoring may, says Clausen, lead to more women having artificial rupture of membranes which in turn can lead to more interventions.

Interestingly, the report cites human rights and ethics as well as evidence from scientific studies to support home birthing. "While the scientific evidence from observational studies has been growing, the European Court of Human Rights in Strasbourg in the case Ternovszky vs Hungary has handed down a judgment stating that 'the right to respect for private life includes the right to choose the circumstances of birth,'" the authors note.

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Source: University of Copenhagen

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