Thursday, November 1, 2012

Is encouraging homebirth in British Columbia to save healthcare dollars going to come at the expense of women and babies?

This morning I woke up to an article in my local paper with the headline Health Minister encourages home births in low-risk cases.

While I support the option of home birth as an informed choice that should be supported with access to qualified and regulated care providers in low-risk situations, encouraging it is another matter, and encouraging it to save money strikes me as being unethical and short-sighted.

I am tremendously thankful that home birth in British Columbia is highly regulated with care providers who are well trained - as it reduces the harm that may be incurred by those who would choose this option anyways. Further, I will begrudge nobody a natural childbirth - if that is what the woman giving birth desires. However, knowing that home birth in the Netherlands has led to low-risk women undergoing home birth to have worse outcomes than high risk women undergoing hospital birth with an OB, gives me pause for thought. The idea that in the vast majority of studies on home birth perinatal and maternal mortality and morbidity is significantly higher than that experienced with hospital birth (with the exception of the one study cited in the article), again gives me pause for thought. Knowing that a low risk woman can go from being low-risk to high-risk in a matter of minutes, further gives me pause for thought. Knowing that some of the consequences of birth gone wrong can be life long and devastating, further gives me pause for thought. Lastly, knowing there's a lot that "low-risk" women, particularly first-time mothers may not be told about birth and its attendant risks, makes me think that encouraging home birth is irresponsible. It also worries me that such a statement coming from the head of the ministry, a former doctor, may make women think that Homebirth is safer than it really is.

Further, such a stance worries me that the Ministry of Health in British Columbia thinks that it is okay to restrict access to medical care for women during labour and delivery for low risk women. After all if low risk women outside of the hospital do not need medical care (epidurals, cesareans) - then why should low-risk women in the hospital need access to these services?

I would further hope that rather than encouraging a risky birth option such as home birth (note this is ALL about saving money) that the Ministry would strive to make safe birth options (in the hospital) more accessible, available, attractive and more cost-effective. Doing otherwise is just saving money at the expense of women and babies - and there's something very wrong with that.


  1. Hi Mrs W, congratulations on your new addition!

    I am a long time Dr Amy reader who just read your comment on this issue. I live in BC, recently had a baby and just wrote the minister a letter to express my shock and horror about this policy change. I would love to add my voice to any other correspondence you have planned.

  2. Hi Brit - email me at