Dr. Chervenak is Given Foundation Professor and Chairman, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, New York.
Dr. Grünebaum is Professor and Director of Obstetrics, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, New York.
The increased risks of planned home birth and the appropriate response of the obstetric profession to planned home birth have become a major focus of our international study group, which includes colleagues in obstetrics from Germany (Birgit Arabin, MD, Phillips Universität Marburg), pediatric neurology from the United Kingdom (Malcolm I. Levene, MD, University of Leeds), pediatrics (Robert L. Brent, MD, PhD, Thomas Jefferson University) and ethics (Laurence B. McCullough, PhD, Baylor College of Medicine). This study group was formed because of the recrudescence of planned home birth in the United States, statements from professional societies and the European court that either sanctioned or supported planned home birth,1,2 and our experience in our medical center with severe complications associated with planned home birth.
In March of 2013 we attended a workshop sponsored by the Institute of Medicine and National Research Council titled An Update on Research Issues in the Assessment of Birth Settings.3 Although there were representatives from the American College of Obstetricians and Gynecologists (ACOG), Society for Maternal-Fetal Medicine (SMFM), American Academy of Pediatrics (AAP), Centers for Disease Control and Prevention (CDC), and other academicians, one of the authors (FAC) presented results of the first analysis of CDC data4 showing the increased risk planned home birth and on the basis of this compelling evidence strongly warned against the dangers of planned home birth.3. pp. 134-136 It was clear to all of the members of our international study group that further analysis of CDC birth certificate data is required to establish a reliable scientific account of the outcomes of planned home birth in the United States.
Here we present the results of the work-to-date of our study group and identify their implications for clinical practice. References provide a comprehensive analysis of the relevant scientific and ethics literature.