Doctors and midwives say more women should be given access to publicly funded home births with hospital back-up after a study found they were associated with low rates of harm for women and their babies.
The first national evaluation of nine publicly funded home birth programs, including the Victorian government's program in Sunshine and Berwick, found low risks of caesareans, haemorrhaging and third-degree perineal tearing. Compared with hospital births, the home births were also associated with a low risk of stillbirth and death for both mothers and infants.
While previous research has raised concern about the safety of home births, it has included women at higher risk of complications rather than only women at low risk who fit the criteria for publicly funded programs with organised hospital back-up.
The evaluation, conducted by the University of Technology Sydney's Centre for Midwifery, Child and Family Health and published in the Medical Journal of Australia, included 1807 women who intended to give birth at home when they went into labour between 2005 and 2010.
It found 1521 or 84 per cent of these women gave birth at home and that 17 per cent were transferred into hospital to give birth or for medical attention in the week after birth. Nine out of 10 women gave birth vaginally and 52 per cent gave birth in water.
None of the mothers died and there were two stillbirths and four early neonatal deaths, although three of these deaths were expected due to previously diagnosed foetal abnormalities.
Professor of midwifery at UTS Caroline Homer said when the expected deaths were excluded, a stillbirth and early neonatal mortality rate of 1.7 per 1000 births was low compared with a rate of about five per 1000 for low-risk women giving birth in hospital.
She said a post-partum haemorrhage rate of 1.8 per cent among the home birth group was also low compared with a rate of about 5-6 per cent for low-risk women in hospital.
Professor Homer said although a study of about 15,000 home births was required to measure safety, the evaluation showed Australia's publicly funded programs were safe for women at low risk of complications and that these programs should be expanded.
Publicly funded home birth options are open to women with low-risk pregnancies who live close to hospitals with midwives.
Professor of obstetrics at Flinders University Marc Keirse praised the study and said publicly funded home births should be expanded because it is a fundamental human right to determine where you want to give birth.
He said the only thing that concerned him was that 75 per cent of women did not receive oxytocin to reduce the risk of haemorrhage after birth - a potentially fatal complication for mothers that cannot be easily managed at home.
Point Cook mother Alice Carr said she felt extremely safe giving birth at home for the first time last month to her fourth son, Blaise. She said Sunshine Hospital's publicly funded home birth program meant she could deliver Blaise in water at home without the stress of having to travel to hospital in labour.
''My midwife was so knowledgeable and really confident and calm. She was brilliant.''