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The safety of home birth continues to raise controversy. Dutch investigators conducted a national cohort study from August 2004 to August 2006 to determine whether women with low-risk, term singleton pregnancies have higher rates of severe maternal morbidity with planned home birth or planned hospital birth. In the Netherlands, most obstetric care to low-risk women is provided by midwives.
Among 146,752 women who were deemed low-risk at the onset of spontaneous labor, 63% had planned home births and 37% had planned hospital births. Severe acute maternal morbidity occurred in 141 women (1.5 per 1000) having home birth and 147 women (2.7 per 1000) having hospital birth. Adverse outcomes were less common with planned home births, although this …