“Home Birth” with an Obstetrician: A Series of 135 Out of Hospital Births

Abstract

Objective: To evaluate the outcomes of properly selected women in an out-of-hospital birth setting with an obstetrician’s unique skills using a midwifery model of care. Design: This is a retrospective review of 135 consecutive out of hospital deliveries over a 56 month period from 2010-2015. Setting: All births took place either in the client’s home or a midwife owned free-standing birth center. Population or Sample: Women were considered candidates if they had no major medical issues, remained healthy and compliant during the prenatal period, went to term and maintained an appropriate maternal positive mindset. Methods: The births include singleton, VBAC, breech and twin deliveries. Main outcome measures: The outcomes of the 135 births are presented in a straight statistical format for comparative analysis with current trends in the hospital birth model. Results: There were 135 women who gave birth to 147 live born infants. 89.6% of the mothers gave birth at home/birth center. The cesarean section rate was 5.9%. There were 96 singleton cephalic births, 27 singleton breech births and 12 sets of twins. There were 32 trials of labor after cesarean (TOLAC) of which 30 were successful vaginal births after cesarean (VBAC) (93.8%). 22 of 27 (81.5%) of the singleton breech babies delivered vaginally. While 11 of 12 (91.7%) of the twin pregnancies delivered at home. Conclusion: Birth at home for properly selected women with a skilled practitioner is a reasonable and ethical option.