The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) said the study also showed the need for a cautious approach amid an overhaul of the nation’s maternity services.
“This study raises again significant concerns about the safety of homebirths,” RANZCOG president Dr Ted Weaver said on Monday.
“We should be very careful when changing current systems of maternity care … that we do not compromise the safety for both the mother and baby and potentially have disastrous outcomes for families.”
The study, published in the Medical Journal of Australia, assessed the outcomes of almost 300,000 births in South Australia from 1991 up to 2006.
Just 1,141 of these were planned homebirths and they were found to result in roughly the same overall rate of child deaths compared to planned hospital births (7.9 deaths per 1,000 planned homebirths compared to 8.2 deaths in planned hospital births).
The major difference was seen in cause of deaths.
Deaths because of a lack of oxygen during birth were 27 times higher among the planned homebirth group.
“Asphyxia death is usually preventable,” Dr Weaver said.
“You can pick up signs that the baby is not coping well … if you look at the reasons behind the babies that died, it was presumably because of differences in how the babies were monitored.”
Dr Weaver also said RANZCOG supported the Rudd government’s moves to tighten laws surrounding homebirths in Australia.
The fact that women were opting for homebirths because of mistrust or worry about the hospital system was also “a concern that should be addressed”, he said.
“Trust and co-operation between all those involved in maternity care is vital to the provision of safe maternity care,” he said.
“Especially if women are transferred to hospital after an attempted homebirth.”
Independent midwives who oversee homebirths in Australia have been operating without professional indemnity insurance since 2001.
Proposed new laws, introduced to parliament last year but not yet passed, would require all midwives to be insured and part of a new national register.
Midwives would also have to work in collaboration with a doctor to access Medicare insurance and pharmaceutical benefits to perform homebirths.