Publicly funded homebirth programs are a safe option for women experiencing low-risk pregnancies, according to new research from the Centre for Quality and Patient Safety at Deakin University’s Institute for Health Transformation (IHT).
Professor Linda Sweet, lead researcher and a member of IHT, says that despite evidence demonstrating the safety and efficacy of homebirths for women experiencing low-risk pregnancies, less than one per cent of births in Australia take place within the home.
Findings from the study have been published in the Australian and New Zealand Journal of Obstetrics and Gynaecology.
“Homebirth is established and recognised as a safe birthing setting in many countries, such as the United Kingdom and New Zealand,” says Professor Sweet.
“In Australia, homebirths have been more contentious as some women seeking homebirth do so following a previous traumatic birthing experience and may not be considered low risk.
“When women with risk factors have a homebirth, the risk of complications rise.
“Whilst there are privately practicing midwives who offer homebirth services on a fee for service basis, there are only 15 health services in Australia that offer a publicly funded homebirth program.
“However, the criteria for inclusion or exclusion to publicly funded homebirth programs are not uniformly consistent, and many are not easily accessible in the public domain. This makes it challenging for woman to make choices for their place of birth.”
To assess the outcomes of a publicly funded homebirth service, Professor Sweet and her team reviewed the referrals of more than 800 women over a ten-year period to Western Health’s publicly funded homebirth service in Melbourne’s west.
Fifty seven percent of the women referred to the homebirth service birthed at home, says Professor Sweet.
“Compared to the women who did not birth at home, those who did were more likely to have previously had a baby,” she says.
“We also found that women who birthed at home were less likely to require suturing or experience blood loss of more than 500mL.
“The infants born at home were more likely to be of normal birth weight when compared to those there were not born at home and significantly less likely to require resuscitation.
“What these findings demonstrate is that appropriate triage and midwifery practice within the clinical guidelines results in a safe homebirth service, enabling choice of birthplace for women with low-risk pregnancies.”
The homebirth service at Western Health is run by a team of dedicated midwives. When joining the service, women are assigned a primary and secondary midwife, who they get to know throughout pregnancy. If the woman requires a transfer from the homebirth service to hospital care, her care continues to be provided by the same midwives, creating a seamless transition from one service to another.
“Midwives have a crucial role in ensuring that women and babies are well-supported during pregnancy and birth, providing maternity care chosen by the woman.
“Whilst some women may need a doctor during pregnancy or birth, every woman needs a midwife.”
The study was supported by a Mavis Mitchell Scholarship at Western Health.
