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literature, professional policy and practice. Planned home births attended by registered professional attendants have not been associated with an increased risk of adverse perinatal outcomes in large studies in North America,1–3 the United Kingdom,4 Europe,5–8 Australia9 and New Zealand.10However, these studies have been limited by the voluntary submission of data,1,4,5,8,10 nonrepresentative sampling,6,7lack of appropriate comparison groups,1,7,9 inadequate statistical power3,8 and the inability to exclude unplanned home births from the study sample.2,11,12

The Society of Obstetricians and Gynaecologists of Canada encourages research into the safety of all birth settings. It does not take a specific stand on home birth.13 In 2008, the American College of Obstetricians and Gynecologists reiterated its longstanding opposition to home births, stating that the choice to deliver at home places the process of giving birth ahead of the goal of having a healthy baby.14 In contrast, the Royal College of Obstetricians and Gynaecologists in the United Kingdom has issued a statement supporting home birth as a viable choice for women with uncomplicated pregnancies.15

In this study, we ascertained outcomes of all planned home births attended by registered midwives in an entire health region with a single-payer universal health care system. We compared them with the outcomes of all planned hospital births that met the criteria for home birth and were attended by the same cohort of midwives. We also compared the outcomes of a matched sample of women of similar risk status who planned to deliver in hospital with a physician in attendance.