March 13, 2006
Home Birth Makes the Hit Parade in British Medical Journal
Home birth appears to be the second most popular subject for readers of the British Medical Journal (BMJ), second only to topics on how to treat heart disease. The BMJ has just released its 2005 annual top 10 list of articles receiving the most attention on the web in the first week after publication.
“Outcomes of planned home births with certified professional midwives: large prospective study in North America,” published last June 18th, 2005, was the third most popular article among several hundred published in the BMJ in the year 2005.
Given that only a minority of women in developed countries choose home births, how is it that such an unlikely topic should hold such a prominent position in one of the most prestigious medical journals in the world? The study is, in fact, timely. Home birthers are statistically among the more educated in developed countries and this study -- the largest prospective home birth study ever published – provides the academic precision to critically juxtapose home and hospital environments and their affect on normal birth.
Hot on the tail of renewed interest in natural birth, studies are presently being formulated to test instead, outcomes when every woman regardless of risk is offered a cesarean section. Popular promotion of this form of childbirth capitalizes on women’s fear by offering them a way to get out of birth, while other women are shocked at such a move so far from the unassisted vaginal birth that they still deliberately choose. In spite of the movement to render vaginal birth an “extreme sport,” it is still preferred by most women in order to have more control and the satisfaction of engaging in a normal biological function that women have performed for centuries. The outcomes in this BMJ article suggest that women are more likely to achieve this if they plan their birth at home.
The BMJ editors one paragraph summary succinctly describes the research:
Giving birth: home can be better than hospital
For women with low risk pregnancies in North America, giving birth at home bears similar risks of intrapartum and neonatal mortality as giving birth in hospital, but planned home births are associated with lower rates of medical interventions. In a prospective cohort study, Johnson and Daviss (p 1416) evaluated the safety of home births involving certified midwives in 5418 women who intended to give birth at home when labour began. The study participants experienced substantially lower rates of epidurals, episiotomies, forceps deliveries, vacuum extractions, and caesarean sections than women with low risk pregnancies who gave birth in hospital.
In the last 12 days of June of 2005, 6,500 different users accessed the article on the web and in July an additional 2,500 different users. Interest has been sustained since then -- 1,250 to 2,000 different users have gone to the article each month since the summer. The abstract has been accessed more than 7,000 times, the full text HTML over 25,000 times and over 6,200 copies of the article have been downloaded as a PDF. In total the article has been accessed in some form almost 40,000 times since publication.
The article and 24 letters to the editor (rapid responses) from around the world are available FREE OF CHARGE at BMJ.com. Go to past issues, choose
June 18, 2005and look under “This Week in the BMJ” to see the summary from the editors and 5 of the letters to the editor from places as far away as . Go to the papers section of that issue to download a copy of the paper and read 19 other letters to the editor (below the article). India
The authors can be contacted for comment or interview at Ken_LCDC_Johnson@phac-aspc.gc.ca , (613) 957 0339 or Betty-Anne@rogers.com , (613) 730 0282.
Other BMJ facts:
709,000 unique users go to the BMJ website every month; monthly page impressions: 6,763,200
The print version of the BMJ goes out to 107,000 subscribers in
and 15,500 subscribers internationally Britain
Local editions of the BMJ (in the local language) are published in
China, Greece, the Middle East, the Netherlands, Portugal, and Romania, South East Asia, Turkey, and West Africa.
Outcomes of planned home births with certified professional midwives: large prospective study in
North America. Kenneth C Johnson, Betty-Anne Daviss. BMJ 2005;330:1416, doi:10.1136/bmj.330.7505.1416 [Abstract]2211 [Abridged text]699 [Abridged PDF]230 [Full text]7681 [PDF]2549