For Your Child

Home Birth Riskier for the Child

A small but growing number of moms-to-be are choosing to deliver their babies at home. But a new study finds that babies born at home are at higher risk for complications, including low Apgar scores and seizures.

Photo of a mother in bed with her newborn, and a toddler looking at the baby

But the study did find that having a certified nurse midwife (CNM) on hand proved to reduce some of those risks, even though CNMs were present at home births only about 26 percent of the time.

Study author Yvonne Cheng, M.D., at the University of California, San Francisco, says the results show that although giving birth at home is a factor in newborn health, having a skilled professional on hand is even more important.

Lower scores

Dr. Cheng and her colleagues studied birth certificate data on nearly 2.3 million single-baby births in the U.S. in 2008. They found that babies born at home were more than twice as likely to have an Apgar score of under 7 as children born in a hospital or at a birthing center. Babies born at home also had double the chances of having a seizure.

The Apgar score is a test used to measure a child's skin color, pulse, and overall vigor in the moments after birth. Babies with lower Apgar scores are more likely to need breathing assistance or require a stay in the ICU, or have seizures and developmental issues.

The study was presented at the annual meeting of the Society for Maternal-Fetal Medicine.

Natural experience

Dr. Cheng says that women often choose to give birth outside of a hospital setting, and without the use of painkillers. They prefer to control their surroundings and have a number of people attend the birth, something not always possible in a hospital setting.

But perinatal specialists like Mary Norton, M.D., at Stanford University Medical Center, say women need to be aware of the risks of home birth.

"Even in a normal-health woman with a normal pregnancy, there will always be unanticipated things that can happen and unanticipated emergencies," Dr. Norton says.

Distance is a factor

Dr. Norton says that birthing at home means that a woman is farther from medical care. Transporting a woman during labor can present special challenges, endangering both mother and child.

"This data does indicate there is a higher level of risk to the baby when delivering at home," Dr. Norton says. "If someone is carefully monitored, is in close proximity to the hospital and willing to go to the hospital if needed, then the risks are lower."

Always talk with your health care provider to find out more information.

Online Resources

(Our Organization is not responsible for the content of Internet sites.)

American College of Obstetricians and Gynecologists - Planned Home Birth

National Women's Health Information Center - Labor and Birth

Our Bodies, Ourselves - Pregnancy and Birth

April 2012

What Is a Midwife?

Midwives can be either certified nurse-midwives, who are both nurses and midwives, or direct entry midwives, who usually focus only on midwifery.

Nurse-midwives are recognized in every state in the U.S. They generally practice in hospitals, clinics, and other medical centers. Nurse-midwives may perform many of the same services as a medical doctor, including physical and gynecological exams, prescribing medicine and contraception, and ordering laboratory tests.

Here are some general descriptions of midwives:

  • Certified nurse-midwife. Certified nurse-midwives are trained in both nursing and midwifery. They have graduate degrees in nursing and must pass certification from the Accreditation Commission for Midwifery Education (ACME), as well as several other national examinations.

  • Certified midwife. Certified midwives are not nurses, but are trained in the practice of midwifery. Most earn graduate degrees in health and sciences, complete education programs in midwifery, and pass the same ACME examinations to receive accreditation and certification.

  • Certified professional midwife. These are credentialed professionals who have met education and training standards determined by the North American Registry of Midwives, the Midwifery Education Accreditation Council, and the National Association of Certified Professional Midwives.

  • Licensed midwife. Licensed midwives receive a permit to practice from a state licensing agency. Not all states offer licenses to midwives. They may also be a certified professional midwife.

  • Lay midwife. A lay midwife is neither certified nor licensed. Although many may be highly competent and have many years of experience, they may not choose to obtain a license, or such certifications may not be available in their state.

Always talk with your health care provider to find out more information.

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