There's good news for North American women who are at low risk for complications and want to give birth at home: Home births aided by a certified professional midwife apparently involve less medical intervention and cause less intrapartum and neonatal mortality—similar to that of low-risk hospital births—according to a recent prospective cohort study.

The study involved 5,418 women who planned to deliver at home. Of those, 655 (12.1%) were transferred to a hospital when labor began, 254 (4.7%) received an epidural, 116 (2.1%) received an episiotomy, 57 (1.0%) required forceps for delivery, 32 (0.6%) required vacuum extraction, and 200 (3.7%) required cesarean delivery. The intrapartum and neonatal mortality was 1.7 deaths per 1,000 planned home births, which was similar to the rate reported in other studies of home births and to low-risk hospital births. No mothers in the study who delivered at home died.

Worth noting is the fact that an uncomplicated vaginal birth in a hospital in the US cost on average three times as much as a birth at home with a midwife.

Johnson KC, Daviss BA. Outcomes of planned home births with certified professional midwives: large prospective study in North America. BMJ. 2005;330:1416-1419.