Where to be Born Safely. Professional Midwifery and the Case against Home Birth

Abstract

Advocates of midwifery have claimed, rather aggressively, that the only remedy for the apparently widespread dissatisfaction felt by women with hospital delivery experiences and obstetricians is a return to the traditional place of birth, the home. They maintain that pregnant women suitable for home delivery can be selected with sufficient accuracy using antenatal risk identification methods.However, women assessed as being of low antenatal risk can suddenly develop dangerous complications in labour, necessitating (if possible) transfer to hospital. Clearly, transfers of this sort inflate hospital perinatal mortality and morbidity statistics and give rise to the fallacious conclusion that home birth is much safer than delivery in hospital. Evidence is presented which convincingly refutes this assumption.Professional midwives urgently require an organization similar to the Canadian Medical Protective Association (CMPA), providing immediate counselling from experienced lawyers and adequate liability insurance to give medico-legal protection far perinatal misadventure in the home.It would appear that professional midwives have mare time to give to the care of pregnant women than do many family physicians. The so-called "low intervention" unit in regional (Level II) hospitals staffed by both midwives and family physicians wouid seem a superior substitute far the home as a setting for birth.