We compared the outcomes of planned home births attended by midwives with those
of planned hospital births attended by midwives or physicians.
Women with low risk pregnancies who choose to give birth at home have a lower risk of severe complications than women
who plan a hospital birth, finds a new study.
Those women who had a relatively difficult previous birth may have been more likely to
plan a hospital birth next time, even if there was no official medical indication.
However, most recent research indicates that, from the point of view of the baby's health and survival, planned home birth in developed countries can be as safe as
planned hospital birth in low - risk pregnancies to parous women [3 — 8].
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.
Although tragic, cord prolapse and AFE occur rarely at homebirth, 1/5000 and 1/500, 000 respectively, when balanced with the dozens of acute emergency conditions endangering the health of mother and baby that occur
at planned hospital birth caused by intervening in the birth process, the scales tip easily in favor of planned attended homebirth for low risk women.
Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe
as planned hospital birth and with less intervention and fewer complications.
SMMIS allows pregnancies to be reasonably objectively classified into different risk categories, thus allowing us to adjust for any bias resulting
from planned hospital births containing a disproportionately high number of so - called «high - risk» cases.
«In this large cohort study, planned home birth in a low - risk population was not associated with higher perinatal mortality rates or an increased risk of admission to a NICU compared to
planned hospital birth after controlling for maternal characteristics.»
The authors report that while perinatal mortality was similar by intended delivery location, the overall neonatal death rate was almost twice as high in planned homebirth
verses planned hospital birth, and almost tripled among nonanomalous neonates (0.3 % and 0.4 %, respectively)(Wax et al, 2010).
Newborns whose mothers planned a home birth were at similar or reduced risk of fetal and neonatal morbidity compared with newborns whose
mothers planned a hospital birth, except for admission to hospital, which was more likely compared with newborns whose mothers were in the physician - attended cohort.
Previous research from the UK and Canada has identified a lower risk of PPH among planned home births than among planned hospital births [4, 11], but the UK study did not attempt to control for confounding variables.
The fact is that
planned hospital births here bear little to no semblance to those elsewhere in the world and your post is one example of why.
One of my favorite doulas in south Florida, Lisa Raynor (right) who works with expecting
moms planning hospitals births in Broward and Palm Beach county, she is well known by nurses, OBGYNS and midwives in Boca Raton Regional Hospital, Northwest Medical Center, Broward Health Medical Center, and far far more.
Research on the comparative safety of different birth settings tends to exclude «high - risk» pregnancy; conventional wisdom states that women with «high - risk» pregnancies should
plan a hospital birth because they are at higher risk of negative pregnancy outcomes.
The finding that the risk of PPH was lower if a home birth was intended even when «high - risk» births were included in the model raises the question of whether it is necessary for all women with «high - risk» pregnancies to be advised to
plan a hospital birth on the grounds of safety.
Unfortunately, there is no way to discern from these data which obstetrical interventions — if any — that were significantly more common among women with
planned hospital births contributed to their reduced rates of perinatal complications and which were «unnecessary.»
the U.S. C - section rate for low risk women
planning a hospital birth lingers around 30 % while women who have planned a home birth or birth center birth have a much lower risk, about 5 %.
First, a little background on the study, Outcomes of planned home birth with registered midwife
versus planned hospital birth with midwife or physician.
«Maternal and newborn outcomes in planned home birth
vs planned hospital births: a metaanalysis» by Joseph R. Wax, MD; F. Lee Lucas, PhD; Maryanne Lamont, MLS; Michael G. Pinette, MD; Angelina Cartin; and Jacquelyn Blackstone, DO, appeared in the American Journal of Obstetrics & Gynecology, Volume 203, Issue 3 (September 2010) published by Elsevier.
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.
The most recent large scale study comparing outcomes for mother and baby reported in the British Medical Journal last month showed that for women who had previously given birth, adverse outcomes were less common among planned home births (1 per 1,000) than
among planned hospital births (2.3 per 1,000).