In moms who had given birth before, the transfer rate was much lower and the baby death rate was not statistically
higher than in the hospital.
We know it's
higher than in hospital, but that is at least partly due to inadequate midwifery education and to some high risk women being considered as suitable candidates for homebirth, so it's a foregone conclusion that the stats will be bad.
Not exact matches
They can steer or nudge people towards lower cost settings like pharmacies [
in the US] that have one - minute clinics rather
than high - cost
hospitals,» he said.
New research published today by the Campaign for Better
Hospital Food shows that at least 1 in every 4 hospital meals (26 %) served to patients in NHS hospitals are likely to be left uneaten and thrown in the bin, a figure higher than previously rec
Hospital Food shows that at least 1
in every 4
hospital meals (26 %) served to patients in NHS hospitals are likely to be left uneaten and thrown in the bin, a figure higher than previously rec
hospital meals (26 %) served to patients
in NHS
hospitals are likely to be left uneaten and thrown
in the bin, a figure
higher than previously recognised.
Even the babies who received human milk only during the time they were
in hospital showed
higher scores
than those who had only formula
in hospital.
In Missouri, the risk of intrapartum death at homebirth is nearly 20 times
higher than hospital birth.
Low risk birth
in the Netherlands at home with a midwife is more likely to result
in a DEAD baby
than high risk birth
in a
hospital with a doctor.
And this paper
in the BMJ suggest low risk moms with midwives at home have a
higher mortality rate
than all the
high risk moms
in hospitals.
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.
I expect the data to be partial, and very slickly presented to put the best spin on it all [something like «90 + % of homebirths are uncomplicated», not that a certain percentage, much
higher than hospital births, result
in death or morbidity].
This is the 4th confirmed homebirth death
in NC this year for a rate that is a whopping TEN times
higher than the rate of death for comparable risk
hospital birth.
In Oregon, babies die at the hands of CPMs at a much higher rate than they do in hospital, comparing low - risk wome
In Oregon, babies die at the hands of CPMs at a much
higher rate
than they do
in hospital, comparing low - risk wome
in hospital, comparing low - risk women.
Breastfeeding rates have been shown to be
higher among babies born
in Baby - Friendly
hospitals than among babies born
in other
hospitals.
There is a much
higher rate of infections to new moms and babies
in hospitals than born at home.
The
higher risk obstetric wards were also really lovely, with communal sitting rooms for post-partum women and the offer of iPod players, electric tealight «candles», electric oil burners, etc. the ob wards were definitely more «sterile»
than the FBCs, but at the end of the day you're staying
in a
hospital, not a five star hotel.
The perinatal (around the time of birth) death rate of babies born
in nonhospital settings is much
higher than for babies born
in a
hospital, even though their mothers are supposedly lower - risk.
In some ways the situation in Israel is better than in the US in that mothers are expected to nurse their babies in the hospital, and there is a very high initiation rat
In some ways the situation
in Israel is better than in the US in that mothers are expected to nurse their babies in the hospital, and there is a very high initiation rat
in Israel is better
than in the US in that mothers are expected to nurse their babies in the hospital, and there is a very high initiation rat
in the US
in that mothers are expected to nurse their babies in the hospital, and there is a very high initiation rat
in that mothers are expected to nurse their babies
in the hospital, and there is a very high initiation rat
in the
hospital, and there is a very
high initiation rate.
Flint and colleagues suggested that when midwives get to know the women for whom they provide care, interventions are minimised.22 The Albany midwifery practice, with an unselected population, has a rate for normal vaginal births of 77 %, with 35 % of women having a home birth.23 A review of care for women at low risk of complications has shown that continuity of midwifery care is generally associated with lower intervention rates
than standard maternity care.24 Variation
in normal birth rates between services (62 % -80 %), however, seems to be greater
than outcome differences between «
high continuity» and «traditional care» groups at the same unit.25 26 27 Use of epidural analgesia, for example, varies widely between Queen Charlotte's
Hospital, London, and the North Staffordshire NHS Trust.
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.
What floors me is how people continue to ignore the glaringly obvious fact, that homebirth, even under the best circumstances, continues to kill mothers and babies at a rate that is far
higher than births that occur
in hospital settings.
Planned homebirth with a licensed homebirth midwife
in Oregon has a death rate 9X
higher than term births
in the
hospital.
Your midwives saw to it that was maintained as well by not warning you that all of the data on homebirth
in the US show a 3 - 8x
higher risk of the baby dying
in homebirth
than in hospital birth.
That's a maternal death rate at home birth more
than 20 TIMES
HIGHER than the maternal death rate
in the
hospital.
She did say that her first two were born
in hospital and her blood pressure was
higher than what is considered normal then, too, but the doctor never did anything about it because it wasn't «too much
higher than baseline» and she never lost protein
in her urine.
The reality, backed by statistics, is that homebirth, even
in countries which have
high licensing standards and good emergency backup systems — which the US most emphatically does not — is far more dangerous
than giving birth
in hospital, grumpy staff or not.
And actually, I just checked the rate at Pullman is
higher than the rate at the two major
hospitals in Spokane!
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.
Second, the authors ACTUALLY showed that homebirth with a CPM
in 2000 had a mortality rate 3X
higher than comparable risk
hospital birth
in 2000.
Women who started birth at home were on average older, of a lower socioeconomic status and
higher educational achievement, and less likely to be African - American or Hispanic
than women having full gestation, vertex, singleton
hospital births
in the United States
in 2000.
Home births (relative risk [RR], 10.55) and births
in free - standing birth centers (RR, 3.56) attended by midwives had a significantly
higher risk of a 5 - minute Apgar score of 0 (P <.0001)
than hospital births attended by physicians or midwives.
I've used the CDC Wonder data from 2003 - 2008 to demonstrate that
in each year, planned homebirth with a homebirth midwives has a neonatal death rate anywhere from 3 - 7X
higher than hospital birth.
And more importantly, rather
than just comparing home vs
hospital overall, it compared midwife - led vs OB - led births at home vs
hospital (as you should well know,
in the Netherlands, low - risk women see a midwife, full stop — you have to be
high - risk to see an OB, so
hospital births are a combination of low - risk women under midwife care and
high - risk women under OB care).
Babies that are born
in the
hospital have a much
higher incidence of infections
in the first month
than babies who were born outside of the
hospital.
«With younger babies, parents always think the crying is going to go on longer
than it usually does,» agrees Pamela
High, M.D., medical director of the infant development unit at Women & Infants»
Hospital,
in Providence.
Note that the total mortality rate for births planned to be attended by direct - entry midwives is 6 - 8 times
higher than the rate for births planned to be attended
in hospitals.
The long - awaited report, written by occupational health specialists at Northwest Community
Hospital, Arlington Heights, stated that the rates of cancer - 25 reported cases
in current and former staff members - and other illnesses at the school were no
higher than normal statewide averages.
The problem is that the risks of a VBAC are not
in fact that much
higher than the risks of other kinds of deliveries that do occur regularly
in hospitals.
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 birth.
In the case of Oregon, homebirth with a homebirth midwife has a death rate 800 %
higher than comparable risk
hospital birth.
It's still measurably
higher risk
than if it's her second uncomplicated pregnancy (and personally I'd rather know
in advance if I were delivering
in the
hospital) but it's not insane.
Post-mortem tests on more
than 500 babies found
high levels of Staphylococcus aureus and Escherichia coli
in babies who died for unexplained reasons, a team from Great Ormond Street
Hospital for Children
in London said on Friday.
You have a
higher chance of complications during labor and birth
than a woman delivering a single baby, so you should plan to deliver
in a
hospital.
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.
Rates of obstetrical intervention are
high in U.S. hospitals, and we found large absolute differences in the risks of these interventions between planned out - of - hospital births and in - hospital births.38 In contrast, serious adverse fetal and neonatal outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyse
in U.S.
hospitals, and we found large absolute differences
in the risks of these interventions between planned out - of - hospital births and in - hospital births.38 In contrast, serious adverse fetal and neonatal outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyse
in the risks of these interventions between planned out - of -
hospital births and
in - hospital births.38 In contrast, serious adverse fetal and neonatal outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyse
in -
hospital births.38
In contrast, serious adverse fetal and neonatal outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyse
In contrast, serious adverse fetal and neonatal outcomes are infrequent
in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyse
in all the birth settings we assessed, and the absolute differences
in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyse
in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of -
hospital births were associated with an excess of less
than 1 fetal death per 1000 deliveries
in multivariate and propensity - score - adjusted analyse
in multivariate and propensity - score - adjusted analyses.
After
hospital transfers were reclassified as belonging to the planned out - of -
hospital birth category, the rate of fetal death was
higher (though not quite reaching the level of significance) among out - of -
hospital births
than among
in -
hospital births (2.4 vs. 1.2 deaths per 1000 deliveries, P = 0.05)(Table 3).
The proportions of women who were white, had private insurance or paid out of pocket, or were of advanced maternal age were
higher among women who planned out - of -
hospital birth
than among those who planned
in -
hospital birth (Table 1).
Similarly, rates of perinatal and neonatal death did not differ significantly before transfers were reclassified (P > 0.1 for all comparisons) but were
higher in the case of planned out - of -
hospital births
than in the case of planned
in -
hospital births after reclassification (perinatal death, 3.9 vs. 1.8 deaths per 1000 deliveries, P = 0.003; neonatal death, 1.6 vs. 0.6 deaths per 1000 deliveries, P = 0.02).
Planned out - of -
hospital birth was associated with a
higher rate of perinatal death
than was planned
in -
hospital birth (3.9 vs. 1.8 deaths per 1000 deliveries, P = 0.003; odds ratio after adjustment for maternal characteristics and medical conditions, 2.43; 95 % confidence interval [CI], 1.37 to 4.30; adjusted risk difference, 1.52 deaths per 1000 births; 95 % CI, 0.51 to 2.54).
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.