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The San Antonio Area Midwives Association


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       Promoting Safe Choices in Childbirth  


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Hospital Birth - How Safe is it?


"Safety" in Childbirth

What does this mean?

What is "safe" enough?


Birth Can Take Place Safely at Home and in Birth Centers

"Highlights of the Evidence" or download "The Evidence Basis for the 10 Steps of Mother-Friendly Care

Resources for more research on the safety of home birth




US Neonatal Mortality Rates by State

Recent Trends in Infant Mortality In the US


The American Public Health Association approved a resolution in 2001 in support of access to out-of-hospital maternity care by qualified providers.

"Increasing Access To Out-Of-Hospital Maternity Care Services Through State-Regulated and Nationally-Certified Direct-Entry Midwives"

APHA Resolution



Site Map

Is Having Your Baby Outside of a Hospital Really Safe?

Contrary to what you may think, giving birth outside of a hospital can be very safe. In fact, for most pregnant women, a planned home or birth center birth with a trained midwife in attendance is actually safer than a planned hospital birth. Study after study has proven this to be true. Because midwives view pregnancy and birth as normal, natural functions of the female body, and trust that birth works best when left alone, most risks can be avoided by not using the interventions that can cause most complications.

The CPM 2000 Home Birth Study

The largest study of home births attended by Certified Professional Midwives, as published in the British Medical Journal, has found that home birth is safe for low risk women and involves far fewer interventions than similar births in hospitals. This prospective study included all home births attended by Certified Professional Midwives across the United States and Canada in the year 2000. Click here for a PDF version of the study: Outcomes of planned home births with certified professional midwives.


The following is written and published by Citizens for Midwifery 2005 Permission to reprint with attribution

Safe & Healthy Outcomes

     Results are consistent with most studies of planned home births and low risk hospital births

     Zero maternal deaths

     Intrapartum and neonatal mortality: 2.0 per 1000 intended home births (only 1.7 per 1000 intended home births when planned breech and twin births are excluded)

     Immediate neonatal concerns resulted in just 2.4% being placed in neonatal intensive care.

     At six weeks well over 90% of mothers were still breastfeeding their babies

Low Rates of Medical Intervention

     Much lower rates of intervention for intended home births compared to low risk hospital births:


Planned home birth

Hospital birth

Induction of labor (only with oxytocin or prostaglandins)

2.1 % *


Stimulation of labor (only with oxytocin)

2.7% *


Electronic fetal monitoring




2.1 %


Vacuum Extraction



Cesarean Section



* These numbers differ from the BMJ article where data for CPMs included forms of induction and stimulation only used by midwives and not comparable to hospital births.

Satisfied Mothers

     Only 1.7% of the mothers said they would choose a different type of caregiver for a future pregnancy.


Few Transfers to Hospital Care

     Only 12.1% transferred to hospital intrapartum or postpartum

     Five out of six transfers were before delivery, most for failure to progress, pain relief or exhaustion

     Midwife considered transfer urgent in only 3.4% of intended home births


High Credibility

     Included all home births involving Certified Professional Midwives in the year 2000

     5,418 women in the U.S. and Canada who intended to give birth at home as of the start of labor

     Prospective - every planned home birth was registered in the study prior to labor and delivery

'Outcomes of planned home births with certified professional midwives: large prospective study in North America.'    ~  Kenneth C Johnson and Betty-Anne Daviss.  BMJ 2005; 330:1416 (18 June).  This article and related letters to the editor are available online, free, at:    Outcomes of Planned Home Births With Certified Professional Midwives





February 2009 San Antonio Area Midwives Association