Home Birth Is Just As Safe As Going To The Hospital For Low-Risk Births, And It Saves Money
When it comes to giving birth, having the home field advantage is not only just as safe as delivering your child in the hospital, it can save you thousands in the long run, according to a recent Canadian study published in PLOS-One .
The study authors found that when looking at the first 28 days after birth, women who gave birth at home under the watchful eye of a midwife, on average, saved $2,338 (USD $1,787) compared to giving birth under midwife supervision at the hospital, and $2,541 (USD $1,942) when only under the care of a physician. These benefits even translated across the first year of infancy, with savings of $810 (USD $626) and $1,146 (USD $875) seen respectively.
The authors studied 9864 women who had given birth in the province of British Columbia: 2243 who planned to deliver their child at home using a registered midwife; 3610 who were set to have their midwife attend their hospital birth; and 4011 who opted to have their child delivered by a physician. All the study subjects were meant to be similar in terms of maternal age, incom, and health status, among other characteristics. And the births were considered low-risk beforehand (217 pairs were excluded from the study because of reported cognitive difficulties upon delivery)
Analyzing the women’s medical records, the authors were able to calculate the amount of money spent as a direct result of the birth during the first month of infancy.
“During the initial 28 days postpartum, average costs per mother were significantly reduced among women planning home birth compared to hospital birth, planned either with a midwife or a physician,” they concluded. “Compared to those who planned hospital birth with a midwife, provider fees, hospital charges, and pharmaceutical costs were significantly less. Compared to planned hospital births with a physician, provider fees and transport costs were higher and hospital costs and pharmaceutical costs were less.”
These findings held true for women who had given birth previously and for first time moms. And were seen during the first 56 days of their child’s life, and up to a full year, making their study the first to compare the two methods of delivery financially that far out in time. It also offers support to the idea that home births can be just as safe as hospital births.
“This is noteworthy because ‘hidden’ risks of home birth, that is morbidity manifesting beyond the immediate postpartum period, if it existed, would be reflected in higher costs during the prolonged period of observation in this study,” they wrote. “However, delayed morbidity does not appear to be a consequence of home birth.”
Pregnant women, at least in British Columbia, are only allowed to use the services of a midwife after careful screening, and so may be particularly healthy compared to the average population. The simple act of omission of not needing to go to the hospital also accounts for a large chunk of the savings. But that these home births can be both safe and less costly is still an important finding, if only because it may dispel unnecessary worries of using a midwife should a family be interested.
"Planned home births attended by regulated midwives save our healthcare system money," said lead author Dr. Patricia Janssen, professor in the School of Population and Public Health at the University of British Columbia, in a statement . "We're trying to produce the kind of data that will inform decision-making both at the policy level and at the individual level. We want women to make the best choice for themselves."
As the researchers note, the Canadian health care system is different than their neighbor below, but there’s some limited evidence showing that home births can be quite the bargain stateside as well.
A 2012 report from the Centers for Disease Control found that home births performed from 1990 to 2009 tended to be less risky than conventional births, being less likely to involve premature and low weight births. And the authors cite a 2007 study of home births in the state of Washington that concluded that they saved an average of $2,971 compared against midwife-attended hospital births and $5,550 against midwife-attended births that involved a cesarean section. At the time of the CDC report, however, less than one percent of the births in the United States annually were home births.
Perhaps with more studies like the current one, that trend will begin to change.
Source: Janssen P, Mitton C, Aghajanian J. Costs of Planned Home vs. Hospital Birth in British Columbia Attended by Registered Midwives and Physicians. PLOS-One. 2015.