AJOG neglects to point out that having only one maternal
death at hospital birth would be a great blessing when in the US annually 277 young healthy women bleed to death among the 1,386,000 cesareans performed each year.
Not exact matches
The regulars here are pretty up on these things and the most recent studies of homebirth have as far as I know have universally shown the homebirth has
at least 3x the perinatal
death rate of similar risk
hospital birth.
In Missouri, the risk of intrapartum
death at homebirth is nearly 20 times higher than
hospital birth.
«While most pregnant women who choose to have planned home
births are
at lower risk of complications due to careful screening, planned home
births are associated with double to triple the risk of infant
death than are planned
hospital births.
We want to know how the
death rate
at homebirth compares with the
death rate
at all
hospital births, not the
death rate
at tertiary facilities.
The
death rate
at CNM attended homebirth is double the
death rate of CNM attended
hospital birth.
The key point for us is that first, it's the US homebirth we generally discuss here and second, it's impossible for a midwife to ensure a safe
birth when after the mother's
DEATH, a trained midwife feels that she, the midwife, is the victim, because the bereaved husband somehow forgot that his wife had a «really lovely spontaneous
birth at home» and listened to her, the midwife, when she told him over the phone that transfer wasn't necessary because her, the midwife's husband, would not have listened to the midwife but to his wife when she told him, «I want to go to the
hospital.»
The authors concluded that the decision to plan a
birth attended by a registered midwife
at home versus in the
hospital was associated with very low and comparable rates of perinatal
death.
Intrapartum and neonatal
death at 0 — 7 days was observed in 0.15 % of planned home compared with 0.18 % in planned
hospital births (crude relative risk 0.80, 95 % confidence interval [CI] 0.71 — 0.91).
In Oregon, there have been
at least 19 newborn
deaths reported to the state over the past decade for a
death rate more than 4 times higher than low risk
hospital birth.
I see it a bit differently — I can't see how a paper that didn't look
at causes of
death, or comment on the neonatal
death rate in comparison to low - risk
hospital birth, made it to publication.
That's a maternal
death rate
at home
birth more than 20 TIMES HIGHER than the maternal
death rate in the
hospital.
Since the chance that the mother would have died in the
hospital is 0.021 %, the excess chance of
death of the mother due to giving
birth at the party is about 0.034 %.
To put this into context, over time, Dr Amy has presented several different lines of hard evidence that the
death rate for babies is higher in home
birth than it is
at hospitals, in America.
How many newborn
deaths at hospitals could have been prevented by home -
birth?
In a later post, there is a link to de Jong admitting that there were 2
deaths at homebirth (one of which was potentially preventable) and 3
deaths in the
hospital group, two of which were unrelated to the
birth at all.
I am not disputing that, but there are enough
births that result in
death in
hospitals by doctors error or not, that it is simplistic and unfair to say that parents who have their children
at home are negligent and don't care about their babies.
Most studies of homebirth in other countries have found no statistically significant differences in perinatal outcomes between home and
hospital births for women
at low risk of complications.36, 37,39 However, a recent study in the United States showed poorer neonatal outcomes for
births occurring
at home or in
birth centres.40 A meta - analysis in the same year demonstrated higher perinatal mortality associated with homebirth41 but has been strongly criticised on methodological grounds.5, 42 The Birthplace in England study, 43 the largest prospective cohort study on place of
birth for women
at low risk of complications, analysed a composite outcome, which included stillbirth and early neonatal
death among other serious morbidity.
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.
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.
High risk
births such as premature, breech and twins ARE
at high risk of perinatal
death and overall have superior outcomes when delivered in
hospital.
When this 20 % risk of
death is compared to the 0.02 % rate of cord prolapse during labor
at homebirth that might have a better outcome if it happened in
hospital, this means that a low risk woman has a 1000 times higher chance of having a life threatening complication either to her life or her fetus / newborns life
at planned
hospital birth, than if she plans to have an attended homebirth with a well - trained practitioner.
The three recent papers published in American Journal of ObGyn: Wax metaanalysis (2010), Chervenak (2013), Grunebaum **** (see note
at bottom)(Apgar 0, 2013) and the U.K.
Birth Place study (2013) report perinatal death rates from homebirth as 3 times or 10 times higher than perinatal death rates in the first week than hospital b
Birth Place study (2013) report perinatal
death rates from homebirth as 3 times or 10 times higher than perinatal
death rates in the first week than
hospital birthbirth.
These
deaths are completely preventable by restricting the frequent use of
hospital interventions that cause them: inductions and augmentations (currently 50 % of low risk
births), forceps & vacuum (5 % of low risk
births), rupturing membranes (85 % of low risk
births), epidurals (50 % of low risk
births), frequent vaginal exams (98 % of low risk
births), general anesthesia
at cesareans (5 % of low risk
births).
When figuring out the rate of perinatal
death for in -
hospital births or out - of -
hospital births, there are four main numbers we're looking
at: total number of
births, total number of term
deaths (past 37 weeks), intrapartum
deaths (during labor), and neonatal
deaths (first 6 days of life).
Many studies of American home
birth show that planned home
birth with a midwife has a perinatal
death rate
at least triple that of a comparable
hospital birth...
All the existing scientific evidence, as well as state and national statistics shows that American homebirth has an increased risk of
death of
at least 3 - 9 times higher than comparable risk
hospital birth.
The neonatal
death rate including the depth and breadth of risk
at hospital births was lower than the self - selected, «low - risk,» health - conscious group who tends to choose home
birth that Johnson and Daviss studied.
Although home birthed infant
deaths are relatively low,
death rates among babies that are birthed
at home are double or triple that of
hospital births.
But a comparison of «low - risk» women who planned to give
birth at home with those who planned to give
birth in
hospital with a midwife found no difference in
death or serious illness among either baby or mother.
There would have to be one or more complications of low risk homebirths that result in
death in the first week that can be prevented by being in
hospital, and
death from these complications would have to occur more often than low risk
deaths at planned
hospital births.
«Among women who intended to
birth at home with midwives in Ontario, the risk of stillbirth, neonatal
death or serious neonatal morbidity was low and did not differ from midwifery clients who chose
hospital birth,» writes Dr. Eileen Hutton, Department of Obstetrics and Gynecology and the Midwifery Education Program, McMaster University, Hamilton, Ontario, with coauthors.
The study, a meta analysis of research from around the country comparing home
births to
hospital births, appeared to show a twofold increase in the rare event of neonatal
death at a home
births.
What the figures in the article show is that if 1000 women went to the
hospital for delivery, and 1000 had their
births at home, there would be 5 times as many
deaths involving the home deliveries as compared to the
hospital deliveries.
The CDC wonder data shows that for women age 20 - 44, giving
birth at at least 36 weeks to babies weighing
at least 2000 grams, no other restrictions (i.e. all races), the
death rate for
birth through day 27 is 0.71 per 1000 for MDs delivering in
hospital, 1.51 for other midwives (non-CNMs) outside of the
hospital.
When your midwives had you provide informed consent to give
birth at home, did they inform you that there are complications that can arise spontaneously in low - risk women that could result in the
death of your son or yourself that could be more safely managed in
hospital?
All sorts of hilarious errors — using one type of data (ICD10 code data from «white healthy women» and essentially comparing the best possible data from one set of
hospital data related to low - risk
births to the worst possible single set of data related to high - risk
at - home
births)-- if you use the writer's same data source for
hospital births but include all comers in 2007 - 2010 (not just low - risk healthy white women), the infant
death rate is actually 6.14 per 1000, which is «300 % higher
death rate than
at - home
births!»
The date clearly is comparable to
birth center and
hospital data, and there is
at least double to 5.5 times the risk of
death.
But the overall risks to the baby remained small regardless of the
birth plan — there were about two
deaths per 1,000
births among planned
hospital births, vs. four
deaths per 1,000
births planned
at home or in birthing centers.
The relative risk of perinatal
death comparing midwife - attended
births at home with physician - attended, planned
hospital births was 2.5 (95 % confidence intervals 0.27 — 24.5).
These data report intrapartum and early neonatal
death rates in full term women who intended to deliver out of
hospital (and subsequently deliver either out of
hospital or in
hospital)
at the start of labor compared with women who intended a
hospital birth (thus «higher risk» pregnancies are included in this group) in 2012.
No, I don't believe that there is a 3 - 4 fold risk of perinatal
death at home
birth because as I said in my comment, we don't have the intrapartum data from
hospitals in order to even make an apples to apples comparison.
In other words, the
death rate
at homebirth is 450 % higher than comparable risk
hospital birth.
The decision to plan a
birth attended by a registered midwife
at home versus in
hospital was associated with very low and comparable rates of perinatal
death.
Yesterday I gave a brief overview of the new MANA statistics paper (Homebirth midwives reveal
death rate 450 % higher than
hospital birth, announce that it shows homebirth is safe) and pointed out that the fact that MANA waited 5 years to release the results demonstrates that Cheyney
at el.
Yet, when I analyzed all of the studies that the Midwives» Alliance of North America (MANA) says comprise the best evidence for the safety of home
birth, I found that every study that looked
at nonhospital
birth in the United States (and many of the studies that looked
at other countries, as well) reported much higher
death rates for babies when compared to similar
hospital births.
When we compare the
death rate
at homebirth of 2.06 / 1000 with the CDC
death rate for low risk white women, ages 20 - 44,
at term, with babies that are not growth restricted of 0.38, we find that homebirth has a
death rate 5.5 X higher than
hospital birth.
Baby
death significantly higher for those delivered
at home or in a freestanding birthing center when compared to those delivered by midwives in the
hospital: Term neonatal
deaths resulting from home
births: an increasing trend
The intrapartum and neonatal mortality among women considered
at low risk
at start of labour, excluding
deaths concerning life threatening congenital anomalies, was 1.7
deaths per 1000 planned home
births, similar to risks in other studies of low risk home and
hospital births in North America.
Maybe I'm wrong looking
at the increased neonatal
death rate in MANA's study, the increased risk of HIE in January 2014 ACOG, the increased risk of Apgars of 0
at 5 minutes (Grunebaum 2014)
at homebirth as compared to
hospital birth.