A pathway to establish a publicly funded home birth program in Australia

Background: Home births provide women a birth choice where they may feel more comfortable and confident in their ability to give birth. Problem: Most women in Victoria do not have publicly funded access to appropriately trained health professionals if they choose to give birth at home. Methods: This paper describes the process of setting up a publicly funded home birth service and provide details of description of the set up and governance. We also report outcomes over 9 years with respect to parity, transfer to hospital, adverse maternal and neonatal outcomes. Results: Of the 191 women who were still booked into the home birth program at 36 weeks gestation, 148 (77.5%) women gave birth at home and 43 (22.5%) women were transferred into the hospital. The overall rate of vaginal birth was also high among the women in the home birth program, 185 (96.9%) with no added complications ascribed to home births. Such as severe perineal trauma [n = 1] 0.6% PPH [n = 4] 2.7%, Apgar score less than 7 at 5 min [n = 0] admissions post home birth to special care nursery [n = 2] 1.35%. Discussion: This unique study provides a detailed road map of setting up a home birth practice to facilitate other institutions keen to build a publicly funded home birth service. The birth outcome data was found to be consistent with other Australian studies on low risk home births. Conclusion: Well-designed home birth programs following best clinical practices and procedures can provide a safe birthing option for low risk women.