The Midwives Model of Care and Home Birth

WHAT IS THE MIDWIVES MODEL OF CARE?

According to the National Association of Certified Professional Midwives, the Midwives Model of Care is rooted in the understanding that pregnancy and birth are normal life processes. This model of care contrasts against the medical model of care and is characterized by:

~ providing the pregnant person with individualized education, counseling and prenatal care, continuous and hands-on support during labor & delivery, and nurturing care throughout the postpartum period;

~ keeping technological interventions to a minimum and only using interventions with the complete informed consent of the birthing person; and

~ referring to physicians identified clients who would be better served with obstetrical care.

For more information see:

https://nacpm.org/about-cpms/midwifery-model-of-care/

WHAT IS HOME BIRTH?

According to Evidence Based Birth, home birth is defined as birth that occurs in one's place of residence. Most of the time (87%), home birth is planned and, while home birth can be attended by physicians, 62% of home births are attended by midwives.

For more information see:

https://evidencebasedbirth.com/what-is-home-birth/

IS HOME BIRTH SAFE?

A 2014 study published by Cheyney et al evaluated the outcomes of care for 16,924 planned home births in the U.S. The study revealed that:

89.1% of women who planned to give birth at home did so
Postpartum maternal (mom) and neonatal (baby) transfers to hospital were infrequent (1.5% and 0.9% respectively)
The intrapartum, early neonatal and late neonatal mortality rates were 1.30, 0.41, and 0.35 per 1,000 births respectively

* the CDC notes a national total infant mortality rate of approximately 6.07 per 1,000 live births in 2016.

For more information, see:

https://onlinelibrary.wiley.com/doi/full/10.1111/jmwh.12172

https://www.cdc.gov/nchs/products/databriefs/db326.htm

CAN ANYONE HAVE A HOME BIRTH?

For some people with preexisting conditions or who develop complications prenatally, home birth may be ill-advised or contraindicated. Some of these conditions include (but are not limited to):

Essential hypertension
Type 1 diabetes
Heart disease
Kidney disease
Blood clotting disorders
Gestational diabetes not controlled with diet and exercise
Placenta previa
Genital herpes outbreak at onset of labor
Prematurity (labor starting before 37 weeks gestation)
Postmaturity (labor starting after 42 weeks gestation)

HOW OFTEN DOES A PLANNED HOME BIRTH REQUIRE TRANSFER TO A HOSPITAL AND WHY?

Evidence Based Birth notes a study by Johnson et al (2005) of over 5,000 women who gave birth at home attended by Certified Professional Midwives. 12% of these women transferred to hospital during labor or after birth. Approximately 75% of these transfers were considered “non-urgent”.

The most common reasons given for hospital transfer were:

Failure to progress (5.7%)
Maternal request for pain relief (2.2%)
Maternal exhaustion (2.1%)

For more information see:

https://evidencebasedbirth.com/what-is-home-birth/

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