NEW YORK (Reuters Health) Jun 16 - Planned home births for low risk women using certified professional midwives are no more likely than hospital births to result in intrapartum and neonatal mortality, according to a report in the June 18th issue of the British Medical Journal. Moreover, the good outcomes are achieved using fewer medical interventions.

Dr. Kenneth C. Johnson, with the Center for Chronic Disease Prevention and Control, and Dr. Betty-Anne Daviss, with the International Federation of Gynecology and Obstetrics, both in Ottawa, Canada, conducted what they believe to be the largest prospective study of planned home births to date.

Included were 5418 women in Canada and the US who planned to deliver at home in the year 2000 using certified midwives. The authors compared outcomes for these women with more than 3 million in-hospital births in the US in 2000.

A total of 655 women (12.1%) were transferred to a hospital. Excluding deaths of babies with fatal birth defects, the rate of intrapartum and neonatal mortality was 1.7 deaths per 1000 births, "similar to risks in other studies of low-risk home and hospital births in North America," the authors write.

The rate of medical interventions was less than half of that observed in the comparison group. For instance, 2.1% of those in the home delivery group underwent episiotomy, compared with 33.0% of those in the control group. Similarly, rates of forceps delivery (1.0% versus 2.2%), vacuum extraction (0.6% versus 5.2%), and caesarean section (3.7% versus 19.0%) were lower in the home delivery group.

The authors contacted approximately 10% of mothers to verify outcomes and to question them regarding their satisfaction with care. For all 11 questions, over 97% reported that they were "extremely or very satisfied."

These findings "support the American Public Health Association's recommendation to increase access to out of hospital maternity care services with direct entry midwives in the United States," Dr. Johnson and Dr. Daviss conclude.