Not exact matches
The study looked at intended place
of birth to rule
out improperly assigning transferred patients to the
hospital group, and included only the
lowest possible risk women.
With a mortality rate
of almost 5x higher than
hospital birth, this is not that far off the 6 - 8 times higher we saw for the Oregon data collection, even though the Oregon group almost surely had significantly fewer criteria for risking mothers
out (no criteria in some places, I'm sure) as well as
lower qualifications for the midwives as CPMs and DEMs.
We paid completely
out of pocket for our elective HB (attempts) and I am fine with that, even though we were
low income and qualified for Medicaid (which is what paid for the
hospital births after transfer).
Evidence shows that
out of hospital birth is as safe as
hospital birth for
LOW RISK women.
The company's statement that
low - risk
births can devolve into emergencies «at
hospitals and at birthing centers» is stunning in its attempt to link
hospitals and
out -
of -
hospital birth centers as equal in some way.
The Canadian study has an unusual way
of calculating perinatal mortality, and the Dutch study points
out that homebirth is as safe as
hospital birth in the Netherlands without addressing the fact that the homebirth population is much
lower risk than the
hospital population.
Intrapartum and neonatal death rates were compared with those in other North American studies
of at least 500
births that were either planned
out of hospital or comparable studies
of low risk
hospital births.
Combined intrapartum and neonatal mortality in studies
of planned
out of hospital births or
low risk
hospital births in North America (at least 500
births)
Although it appears that the preventable newborn deaths at home and
hospital birth balance
out, homebirth is clearly safer when you take into consideration the risk
of maternal death that 20 %
of low risk U.S. women face as a result
of avoidable cesareans which became necessary because they went to
hospital.
Having a home
birth because the risk is there, but it's
low and you figure most
births are uncomplicated and since your wife is
low risk, choosing the more cost efficient home
birth route makes more sense since you MAY have problems with at home, but paying
out of pocket for
hospital care is for sure an expense you can't afford when everything is most likely going to be ok anyway.
I found the workshop rather ill - informed on the risks
of taking VBAC clients in
out -
of -
hospital birth centers, instead the push from the AABC, as well as the CNM workshop leader was to advocate for VBAC in
low - resource settings, such as their accredited
birth centers.
«The planned category
of out -
of -
hospital births is seen to be a generally
low - risk group for neonatal mortality, with very few
low -
birth - weight
births and fewer teenage,
low - educational levels and unwed mothers than found statewide, «the researchers said.
Out -
of -
hospital births were also associated with a higher rate
of unassisted vaginal delivery and
lower rates
of obstetrical interventions and NICU admission than in -
hospital births, findings that corroborate the results
of earlier studies.3 - 5 These associations follow logically from the more conservative approach to intervention that characterizes the midwifery model
of care8, 19 and from the fact that obstetrical interventions are either rare (e.g., induction
of labor) 20 or unavailable (e.g., cesarean delivery, whether at home or at a
birth center) outside the
hospital setting.
The odds
of cesarean section among women planning
out -
of -
hospital birth were
lower among multiparous women than among nulliparous women and among women with 12 years
of education or less than among women with more than 12 years
of education (Figure 1).
Perinatal mortality was higher with planned
out -
of -
hospital birth than with planned in -
hospital birth, but the absolute risk
of death was
low in both settings.
If all
low risk women were being cared for by midwives in
out of hospital settings, we would see better outcomes, healthier mamas and babies, and women would be able to tell their
birth story with confidence that they had control.
The odds for neonatal seizure were higher and the odds for admission to a NICU
lower with planned
out -
of -
hospital births than with planned in -
hospital birth.
An UpToDate review on «Planned home
birth» (Declercq and Stotland, 2015) stated that «Large cohort studies using intent - to - treat analysis
of midwife - attended, planned,
out -
of -
hospital birth of low - risk women in developed countries have reported reduced rates
of cesarean
birth, perineal lacerations, and medical interventions, and similar rates
of maternal and early perinatal morbidity and mortality compared to planned
hospital birth.
The authors concluded that perinatal mortality was higher with planned
out -
of -
hospital birth than with planned in -
hospital birth, but the absolute risk
of death was
low in both settings.
It was a welcome interlude to the chaos that had yet to come, because as soon as I got to the
hospital, my
birth plan —
of free movement,
low chemical interventions, non-neon light — went
out the window.
but i wouldn't rule
out low risk
birth, close to
hospital i case
of emergency with a professional and registered midwife as being worse than being in
hospital.
For planned
out -
of -
hospital births, there was an increase in some complications, such as seizures and
low Apgar scores (a measure
of a newborn's overall health), but the absolute risk remained
low.
Planned
out -
of -
hospital birth also had a statistically significant association with higher rates for 5 - minute Apgar scores
of less than 7, neonatal seizures, neonatal ventilator support, maternal blood transfusion, and unassisted vaginal delivery but with
lower rates
of both admission to neonatal intensive care units and obstetrical interventions, including induction and augmentation
of labor, operative vaginal delivery, cesarean delivery, and severe perineal lacerations.
A number
of non-invasive, non-pharmocological solutions have been shown scientifically to be as effective as active management in
lowering cesarean section rates: a companion in labor in the
hospital (Thornton and Lilford 1994), midwives rather than doctors as the principle
birth attendants in
hospital births of women without complications (Wagner 1994),
out -
of -
hospital birth centers (Rooks et al. 1990), and planned home
birth (Wagner 1994).
How, how, how, would an
out of hospital birth NOT result in dramatically
lower instances
of induction, augmentation, anaesthesia, etc?
Opting for an
out -
of -
hospital birth is desirable for many women not only because it's more relaxing and comfortable, but also because there are fewer interventions and
lower risk
of infection.