While the majority of women in the United States give birth in the hospital setting, some families prefer to plan a home birth or birth at home. In the context of Midwifery care, women are encouraged and supported to make informed choices regarding the type of maternity care experience that will best meet their individual needs, including location for the birth experience.
Our process of informed choice for the selection of birth site includes the following:
- Delineation of potential risks and benefits of each available birth site,
- Evaluation of transport mechanisms if conditions require personnel and/or equipment available only in the hospital setting
The safety of birth in any setting is of utmost priority and has been the focus of home birth research. Investigators have defined “planned home birth” as the care of selected pregnant women by qualified providers within a system that provides hospitalization when necessary. Recently, well designed controlled trials and descriptive studies have demonstrated that planned home births achieve excellent perinatal outcomes.
These high quality investigations of the safety of home birth indicate that optimal outcomes are associated with appropriate client selection, attendance by a qualified maternity care provider, and integrated systems that support collaborative care when a change of site is indicated. Home birth is also credited with the reduced use of medical interventions that are associated with perinatal morbidity.