Personally, I think it's curious how many physicians and mothers - to - be place such a high emphasis on the 0.11 % risk reduction of
neonatal mortality from hospital births, while thinking nothing of engaging other common practices (i.e. poor dietary habits, overuse of antibiotics, participation in contact sports) that certainly increase their child's lifetime risk of chronic disease, injury, or even death.
I do think it is unethical to deride a woman for deciding that something else did in fact outweigh the 0.11 % increased risk of
neonatal mortality from attempted homebirth.
Not exact matches
Rather than using
neonatal mortality (birth to 28 days) or perinatal
mortality (
from 28 weeks of pregnancy to 28 days of life), they used deaths
from 20 weeks of pregnancy to 7 days of life.
That book is full of misinformation, for example he cites the Johnson & Daviss study saying «any remaing doubts about the safety of home birth were conclusively erased» by said study — which isn't even remotely true (the home birth data
from that study actually shows that
neonatal mortality is 3 TIMES higher at home):
The latest data
from the CDC (available on the CDC) Wonder website shows that homebirth with a non-nurse midwife has a
neonatal mortality rate more than 7 times HIGHER than low risk hospital birth.
Internationally it is one of the few, and the largest, prospective studies of home birth, allowing for relatively stable estimates of risk
from intrapartum and
neonatal mortality.
Our analysis focused on personal details of the clients, reasons for leaving care prenatally, the rates and reasons for transfer to hospital during labour and post partum, medical interventions, health and admission to hospital of the newborn or mother
from birth up to six weeks post partum, intrapartum and
neonatal mortality, and breast feeding.
The meta - analysis include two large studies
from The Netherlands and Canada, both of which showed no difference in perinatal and
neonatal mortality rates.
The following chart, adapted
from Infant,
neonatal, and postneonatal deaths, percent of total deaths, and
mortality rates for the 15 leading causes of infant death by race and sex: United States, 2007 makes that clear.
At an excess rate of
neonatal mortality of 9/1000, we could expect that 630 babies would die
from preventable
neonatal deaths each year.
From 1970 - 1980, the C - section rate rose precipitously, and the
neonatal mortality rate also dropped precipitously.
The numbers I had come across (long before I ever came to this site)
from published research was 0.09 %
neonatal mortality rate in the hospital vs 0.20 % in the hospital.
However, they noted a smaller study of all planned home births attended by midwives in British Columbia, Canada,
from 2000 to 2004 that showed no increase in
neonatal mortality over planned hospital births attended by midwives or physicians.
However, the rapid increase in cesarean birth rates
from 1996 to 2011 without clear evidence of concomitant decreases in maternal or
neonatal morbidity or
mortality raises significant concern that cesarean delivery is overused.
Neonatal mortality represents deaths
from birth to 27 days after birth.
More recently,
neonatal mortality for infants with birth weights
from 751 to 1,000 gm has improved: for 1977 to 1980, it was 28 % (33/118).
On the other hand, for a first time mother with no complications at the start of labor, the Birthplace Study found a nearly 3 x greater risk of intrapartum /
neonatal loss, and the data
from the Netherlands suggests that although the rates aren't high enough to affect the overall perinatal
mortality rate, there are greater risks out of hospital if a complication does occur.
Therefore, it is possible to look specifically at
neonatal mortality (death within 1 hour to within 28 days of age) for babies of white women (almost all homebirths are to white women) ages 20 - 44, singleton pregnancies, at term (37 + weeks), not suffering
from intrauterine growth restriction (2500 + gm).
I pulled
neonatal mortality rates
from the Wonder Database, searching for criteria that matches the MANA study as closely as possible (White women, Singles and twins, 37 weeks and above, Birth weight of 2500 grams or more, Live birth through 27 days, Years 2004 - 2009; it includes everything else: all ages, all education levels, all marital statuses, etc).
The objective set forth at the outset of the article was to examine «outcomes
from planned home births» yet the conclusion regarding
neonatal mortality clearly states it is only counting «low - risk women in this cohort.»
Effect of early infant feeding practices on infection - specific
neonatal mortality: an investigation of the causal links with observational data
from rural Ghana Karen M Edmond, Betty R Kirkwood, Seeba Amenga - Etego, Seth Owusu - Agyei, and Lisa S Hurt Beginning Breastfeeding From First Day of Life Reduces Infection Related Deaths in Newborns by 2.6 ti
from rural Ghana Karen M Edmond, Betty R Kirkwood, Seeba Amenga - Etego, Seth Owusu - Agyei, and Lisa S Hurt Beginning Breastfeeding
From First Day of Life Reduces Infection Related Deaths in Newborns by 2.6 ti
From First Day of Life Reduces Infection Related Deaths in Newborns by 2.6 times.
The excess total
neonatal mortality for deliveries performed by home midwives was 9.3 / 10,000 births or about 18 - 19 excess
neonatal deaths a year
from midwife homebirths.
Based on the most recent 2012 births data, the authors concluded that if home births by midwives continue to grow at the present 10 percent yearly rate, then the excess total
neonatal mortality of home births by midwives would nearly double
from about 16 - 17 in 2009 to about 32 in 2016.
There were no significant differences between male and female fetuses born at comparable gestational ages regarding
neonatal mortality; however, males were at significantly increased risk of composite
neonatal morbidity compared to females
from 29 weeks onward with a peak at 37 - 38 weeks.
The research, conducted by experts
from BCM, the Texas Department of State Health Services, University of Texas Southwestern Medical Center in Dallas and the University of South Florida, used the Texas Department of State Health Services» Texas Birth Defects Registry data
from 1999 - 2007 to retrospectively examine the associations between distance
from birth center to a cardiac surgical center, number of newborns cared for with HLHS at each hospital, and
neonatal mortality in infants with HLHS.
Overall, in the latest years of the study, newborns with a prenatal diagnosis, born less than 10 minutes
from a cardiac surgical center, and cared for at a large volume cardiac surgical center, had a
neonatal mortality of 6 percent.
A first - of - its - kind study led by Texas Children's Hospital and Baylor College of Medicine (BCM), published online in the journal, Circulation, found that infants with hypoplastic left heart syndrome (HLHS) born far
from a hospital providing
neonatal cardiac surgery for HLHS have increased
neonatal mortality, with most deaths occurring before surgery.
Since the establishment of the first US
neonatal intensive care unit (NICU) in 1960,1 the
neonatal mortality rate has fallen more than 4-fold,
from 18.73 per 1000 live births to 4.04 per 1000 live births in 2012.2 Much of this decline can be attributed to the highly specialized care provided to premature and sick infants by neonatologists and multidisciplinary teams working in NICUs.3, 4
In cases of
neonatal mortality, the diagnosis typically is made postmortem with virus isolation
from fresh lung, liver, kidney, and spleen by cell culture techniques and subsequent identification by PCR and sequencing, transmission electron microscopy, immunofluorescence, or fluorescence in situ hybridization.