Across the world, most of today's newborn babies are born at home, although, particularly in westernised countries, we have had an obvious move from home to hospital birth which began in 1745. This was the time when women of lower socio-economic status were offered the opportunity to birth in hosptial so that the male childbirth assistants could practice their skills. From that time onwards, giving birth in hospital was increasingly seen as a dangerous practice, due to "childbed fever" which is reported to have killed 13 per cent of women under the care of doctors in Vienna in 1846, compared with two percent of women under the care of midwives. Problems of the time were attributed to the "crowding of patients, frequent vaginal examinations and the use of contaminated instruments, dressings and bed linen" (Da Costa:2002, in Buckley, SJ:2005:228). Of course, there was a strong resistance to the fact that the doctors themselves could have been causing the high infection rate, however, by the end of the nineteenth century, aseptic techniques began to make their way into normal hospital practice. Subsequently, the maternal mortality rate for women birthing in hospitals began to improve.

Despite our cultural move to hospital birthing, in westernised countries homebirth was still the norm until around the 1950's (Buckley:2005:228). Many of our great-grandparents, grandparents and possibly even our parents were born at home. The most recent research contained in the Cochrane systematic review of the literature,  (published on the Cochrane database; the source from which our hospital policies are usually created),  still states that there is not enough evidence to decide one way or another, whether home or hospital birth is safer (Olsen & Jewell: 2000 (CD000352) in Hofmeyr et al:2008:252). In fact, Hofmeyr goes on to say, on behalf of the Cochrane database; "The relative benefits and risks of different settings are difficult to quantify. For a woman and her baby with no complications, the risk of an unexpected adverse event during a home birth may be smaller than risks specific to hospitalisation, such as hospital-aquired infections" (Hofmeyr et al:2008). Olsen and Jewell (2000), the authors of the systematic review also state: "In countries where it is possible to establish a home birth service backed up by a modern hospital system, all low-risk women should be offered the possiblity of considering a planned home birth...." (Olsen & Jewell: 2000 (CD000352) in Buckley:2005:230).

Today, publicly funded home birth programs exist in almost every state in Australia, and in other countries such as New Zealand, Netherlands and the United Kingdom, with statistics continuing to show outcomes that are at least as good as hospital births for both mothers and their babies.

_References:

_{Buckley, S: 2005: Gentle Birth, Gentle Mothering; One Moon Press, Brisbane.}

_{Hofmeyr et. al.: 2008: A Cochrane Pocketbook; Pregnancy and Birth: John Wiley & Sons Ltd, West Sussex.}