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.
Not exact matches
If insurance companies want to force mothers to
birth in
hospitals where many women are coerced into c - sections, they need to
at least stand behind their decision by giving these women the regular -
rate coverage they deserve!
Most people that choose to
birth at home have only chosen after extensive research and feel that the small risk of a serious complication is preferable to the high
rate of intervention in a
hospital setting (including the 33 % national caesarean section
rate.)
Most people that choose to
birth at home have chosen this option after extensive research and feel that the small risk of a serious complication is preferable to the high
rate of interventions in a
hospital setting (including the 33 % national caesarean section
rate, 45 %
at some local
hospitals).
Most people that choose to
birth at home have only chosen after extensive research and feel that the small risk of a serious complication is preferable to the high
rate of interventions in a
hospital setting (including the 33 % national caesarean section
rate.)
Rates of acute emergencies for low risk
births at planned attended homebirth vs planned
hospital birth:
The option of a C - section is real for a percentage of
births, but there is an alarmingly high
rate of C - sections
at our local
hospital — 1/3 of all
births there end in surgery.
Perinatal mortality
rates for
hospital births of low risk women are similar to outcomes of planned homebirth in general, but the maternal morbidity
at planned
hospital births is much higher.
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.
Mothers who give
birth at home are as concerned with the under - reported and grossly high maternal mortality
rate in
hospitals as the infant mortality
rate.
The death
rate at CNM attended homebirth is double the death
rate of CNM attended
hospital birth.
I will be giving
birth with a midwife
at a
hospital that has a c - section
rate half the state average (Arizona being the state).
My healthy baby died because the midwife
at the
birth center did not pick up the falling heart
rate and by the time I was blue - lighted to a
hospital, it was too late to resuscitate my boy.
Low risk women in primary care
at the onset of labour with planned home
birth had lower
rates of severe acute maternal morbidity, postpartum haemorrhage, and manual removal of placenta than those with planned
hospital birth.
Oh yea, and they kill babies
at a much higher
RATE compared to comparable risk
hospital birth.
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.
In a randomised controlled trial comparing community based care with standard
hospital care a significant difference in caesarean section
rates was found (13.3 % v 17.8 % respectively).29 Planning a home
birth30 or booking for care
at a midwife led
birth centre is also associated with lower operative delivery
rates.
C - section
rates for first time mothers varied from 22.95 % in Sligo General up to 40.15 % in St Luke's
Hospital Kilkenny with both units also reporting extremely low vaginal
birth of Caesarean
rates at 0.93 % and 3.51 % respectively.
Twelve critical success factors, including «the right attitude, focus, leadership, teamwork, support, and a personal and financial commitment to best practice and continuous quality improvement,» were identified, based on practices
at four Ontario
hospitals with comparatively low caesarean
rates.19 The «right attitude» included taking pride in a low caesarean
rate, developing a culture of
birth as a normal physiological process, and having a commitment to one to one supportive care during active labour.
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.
Conclusions: Low risk women in primary care
at the onset of labour with planned home
birth had lower
rates of severe acute maternal morbidity, postpartum haemorrhage, and manual removal of placenta than those with planned
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.
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.
That's a maternal death
rate at home
birth more than 20 TIMES HIGHER than the maternal death
rate in the
hospital.
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.
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.
The point is that, although yes, some women and babies still die in the
hospital: First: That number is FAR LOWER than what it was when everyone gave
birth at home Second: OBs and medical professionnal are constantly trying to improve their methods and reduce the mortality
rate even more.
The authors describe how 90 % of mothers initiate breastfeeding
at birth, yet very quickly after
hospital discharge these
rates fall and neither exclusive breastfeeding, nor duration, come close to the WHO / UNICEF infant feeding recommendations.
It showed that for low - risk women, giving
birth at home or in the
hospital gave an even
rate of -LSB-...]
The two larger
hospitals have lower c - section
rates than the smaller
hospital closest to me and they also boast women's clinics with multiple midwives on staff, but my homebirth midwife recommended an OB
at the closer
hospital — a personal friend of hers — who had given
birth her own child
at The Farm (with Ina May as a back - up midwife!)
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.
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).
We know from the UK Birthplace study that, with fully trained MWs cooperating within the health system, tight risk - out and 40 % transfer
rate, the babies of first - time mothers still die
at 3X the
rate of similar
hospital births (quite aside from hypoxic and physical injury).
There is no research on the
rate of infection
at low risk planned attended homebirths, but in theory homebirth prevents infection and
hospital birth increases the risk of infection.
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...
Episiotomy,
hospital birth and cesarean section: technology gone haywire — what is the sutured tear
rate at first
births supposed to be?
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.
Furthermore, preferring a
birth with midwife - led care — both
at home and in
hospital - was associated with lower
rates of induced labor and lower
rates of epidural analgesia.
In 2012, the home
birth rate in Oregon was 2.4 %, which was the highest rate of any state; another 1.6 % of women in Oregon delivered at birth centers.11 Before licensure became mandatory in 2015, Oregon was one of two states in which licensure was not required for the practice of midwifery in out - of - hospital settings.12 Although the 2003 revision of the U.S. Standard Certificate of Live Birth distinguishes planned home births from unplanned home births, at the national level there is still no way to disaggregate hospital births that were intended to occur at a hospital and those that had not been intended to occur at a hosp
birth rate in Oregon was 2.4 %, which was the highest
rate of any state; another 1.6 % of women in Oregon delivered
at birth centers.11 Before licensure became mandatory in 2015, Oregon was one of two states in which licensure was not required for the practice of midwifery in out - of - hospital settings.12 Although the 2003 revision of the U.S. Standard Certificate of Live Birth distinguishes planned home births from unplanned home births, at the national level there is still no way to disaggregate hospital births that were intended to occur at a hospital and those that had not been intended to occur at a hosp
birth centers.11 Before licensure became mandatory in 2015, Oregon was one of two states in which licensure was not required for the practice of midwifery in out - of -
hospital settings.12 Although the 2003 revision of the U.S. Standard Certificate of Live
Birth distinguishes planned home births from unplanned home births, at the national level there is still no way to disaggregate hospital births that were intended to occur at a hospital and those that had not been intended to occur at a hosp
Birth distinguishes planned home
births from unplanned home
births,
at the national level there is still no way to disaggregate
hospital births that were intended to occur
at a
hospital and those that had not been intended to occur
at a
hospital.
In recent years, U.S.
rates of planned out - of -
hospital birth (i.e.,
births intended to occur
at home or
at a freestanding
birth center) have increased.
Estimates of the numbers of women booked for home
birth but delivering in
hospital were even more difficult to obtain because
hospital records do not always specify this information accurately and no national estimate exists.1 4 Data collected in this region in 1983 suggested that 35 % of these women changed to
hospital based care either before or during labour, and a more detailed prospective study of all planned home
births in 1993 found a total transfer
rate of 43 %.8 Women were classified as having booked for a home
birth when a community midwife had accepted a woman for home delivery and had this arrangement accepted by her manager and supervisor of midwives
at any stage in pregnancy, irrespective of any later change of plan.
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.
DR. STUART FISCHBEIN: Usually [00:16:25] is something that I do because as the
hospital birth practitioner when it gets to somewhere all other things are not working and then the possibility is to do an external cephalic version which is a hand - on technique to try and turn the baby, and that is usually done in the
hospital described that in just a second but the way I do it because I don't use meditation, I often will have a woman spend
at least thirty minutes prior to the procedure with a medical therapist to put her in a relaxed state, I do believe there is pretty good evidence out there that this increases the success
rate by just being totally relaxed.
If you were to look
at national statistics — which includes high - risk women who give
birth in the
hospital — it would not be appropriate, for example, to compare your c - section
rate to Vital Records data on c - section
rates.
So a team of Dutch researchers decided to test whether low risk women
at the onset of labour with planned home
birth have a higher
rate of rare but severe outcomes (known as severe acute maternal morbidity or SAMM) than those with planned
hospital births.
Overall, they conclude: «Low risk women in primary care with planned home
birth at the onset of labour had a lower
rate of severe acute maternal morbidity, postpartum haemorrhage, and manual removal of placenta than those with planned
hospital birth.
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.