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And “the safest setting for labor, delivery and the immediate post-partum period is in a hospital or a birthing center within a hospital.”

“The most comprehensive study of this was published in the British Medical Journal in 2005,” says Melissa CHEYNEY.

“It showed that for low-risk [home] births in the U.S. and Canada, the infant mortality rate was roughly 1.7 per 1,000, or about the same as it is in hospitals.”

“We’ve been getting a lot of insight into their world view,” CHEYNEY says, “and it’s been illuminating.”

“The U.S. has a limited idea of what it means to have a positive outcome at the end of a delivery,” she says.

“Basically it just means that everyone’s alive. But when you don’t have a lot of medical intervention, you also tend to have more breast-feeding and reduced rates of postpartum depression.”

“We do think [sampling bias] is true for about half of them,” she says. “We see women who are very well-educated and healthier to begin with and that helps them have better outcomes having home delivery. But the other big group is the uninsured or underinsured. They tend to have poor outcomes in the medical establishment but do better with home care or birthing center care.”

CHEYNEY says “a model for collaborative care that will be the first of its kind in the United States.”Via