“Having a home birth may be like not putting your child’s car seat belt on,” the researchers write in a paper published Wednesday in the Journal of Medical Ethics
“Most children will be unharmed. Some trips are very safe. And wearing a seat belt will not remove all risk of injury or death… But on balance it is much safer with a seat belt.”
The main worry is that there are few resources to quickly detect and deal with any complications that arise during a home birth, which can put the health and well-being of the baby at risk, write the researchers – Australian obstetrician Dr. Lachlan de Crespigny and Oxford University ethics professor Julian Savulescu.
Indeed, babies born at home are about 10 times as likely to be stillborn compared to babies born in hospitals, according to a study published last fall in the American Journal of Obstetrics and Gynecology. They're also almost four times as likely to have neonatal seizures or serious neurologic dysfunction.
But doctors and midwives often do not tell patients about the potential dangers involved in home birth and medical literature does not adequately address the risk of long-term disability, de Crespigny and Savulescu write. Doctors should not support planned home birth when there are “safe and compassionate hospital-based alternatives,” they add.
While fewer than 1 percent of women give birth at home in the U.S., the home birth rate increased by almost a third from 2004 to 2009, according to the CDC. Home births are more common among women aged 35 and over, and among women with several previous children.
Home births are more common in the U.K. and some European countries than they are in the U.S., though they still represent a small minority of births.