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Today marks the long-anticipated publication of two articles on the outcomes of the Midwives Alliance of North America Statistics Registry (MANA Stats).

We are very excited to share with you the findings - and how you can help spread the word. But first, the findings:

Key findings of the study

This is the largest ever look at planned home births in the U.S., examining nearly 17,000 births.

This study joins a growing body of research that shows that, for low-risk women, home birth with a skilled midwife is a safe option that has health benefits for mothers and babies.

The study has implications far beyond home birth, because it shows the benefits of normal physiologic birth, which can be supported in any setting.

Today’s study - unlike recent anti-home birth research that relies on birth certificate data - is based on the MANA Stats registry. The MANA Stats registry contains high-quality data that uses the gold standard - the medical record - instead of birth certificate data, which is notoriously unreliable for studying intended place of birth and newborn outcomes.

More detailed findings

For planned home births with a midwife in attendance, key outcomes include:
  • Over 93% women had a normal physiologic birth
  • A cesarean rate of 5%
  • Only 2.5% of babies admitted to the NICU in the first six weeks of life
  • 87% of women with previous cesareans had their babies vaginally
  • Of the 10.9% of women who transferred from home to hospital during labor, the majority moved for non-emergent reasons, like a slow, non-progressing labor, or maternal exhaustion
  • At six weeks postpartum, nearly all babies were breastfed
While we can’t make a direct comparison to hospital outcomes (because they include women with different risk factors), we are happy to see such low intervention rates and high breastfeeding rates without increasing risk to mother and baby.

Rates of fetal and newborn death were very low for babies without congenital anomalies: the risk of death to the fetus or newborn (including during labor, in the first week of life, or the first 28 days of life) was about 2 per 1,000.

The risk of fetal and newborn death are even lower when women in higher-risk categories were excluded. When breech, previous cesarean, multiples, preeclampsia, and gestational diabetes were removed, the risk of death was about 1.6 per 1000. These rates are in line with other well-designed studies that look at home birth. In particular, babies born in the breech position appear to have the highest risk.

At the conclusion of midwifery care, 98% of babies were being breastfed; 86% were exclusively breastfed.  Nationally, only 77% of babies even begin breastfeeding, and we know how important this is to the lifelong health of babies and their mothers.

We need your help to spread this good news!

We’ve all read about the poorly designed research or data releases that suggest home birth isn’t safe. Opponents of a woman’s right to choose her place of birth have made sure those numbers have been widely spread. But together, we can ensure that women receive the accurate information they need to make well-informed decisions about their health care.

Here’s how you can help

First, you can learn more by reading our summary of findings here on the MANA blog. While you are there, please stop by the comments section and leave a note.

Next, share the blog post widely on your Facebook page, on listservs, and with your community.

While you are on Facebook, please consider stopping by the MANA page and sharing some of the visuals we designed to help educate consumers about the research. Please leave a comment too; every comment you leave means more people will learn about the positive outcomes of midwifery.

You can also find a link to a fact sheet about the research to share with consumers over at the Citizens for Midwifery site.

Please join us in gratitude

Please join us in thanking the many, many people who have made this possible, including the homebirth midwives who have diligently contributed to the MANA Stats database.

We also thank the members of the MANA Division of Research who created the system, continually improved it over the years, and have put quality assurance processes in place to make sure the data are sound.

We are very grateful to the Foundation for the Advancement of Midwifery for providing ongoing financial support for the MANA Statistic Project.

And finally, we thank the researchers who validated and analyzed the data and shepherded these articles down the long road to publication.


Jeanette McCulloch, MANA Communication Director and
The MANA Board of Directors
Copyright © 2014 Midwives Alliance of North America, All rights reserved.

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