Home versus hospital birth: Questioning the quality of the evidence on safety

2003    Vedam S. (2003). Home versus hospital birth: questioning the quality of the evidence on safety. Birth, 30(1): 57-63. 



The home versus hospital birth study by Pang et al has aroused immediate controversy. The American College of Obstetricians and Gynecologists headlined its press release as, “Home Births Double Risk of Newborn Death” (1). Another journal review was titled “Infants Born at Home are Twice as Likely to Die as Those Born in Hospitals” (2). In contrast, the Midwives Association of Washington State press release stated that “Childbearing women and health policy makers should be made aware that the study contains numerous flaws and limitations….this study alone should not be used to make decisions that could restrict women’s choice of birth place or access to birth attendants with expertise in home birth” (3,p1). In addition, the press release from the American College of Nurse-Midwives was titled, “Latest Study on Home Birth: Authors Acknowledge Inability to Draw Conclusions” (4). Who is right? What is the responsible reaction to this study? Can the “safety” of various birth sites be determined? If so, under what conditions is home birth safe?

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