Not exact matches
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).
The odds of cesarean section
among women planning out - of -
hospital birth were lower
among multiparous women
than among nulliparous women and
among women with 12 years of education or less
than among women with more
than 12 years of education (Figure 1).
Obstetrical procedures were more common
among women who had planned in -
hospital births than among women who delivered out of the
hospital (30.4 % vs. 1.5 % for induction of labor and 26.4 % vs. 1.1 % for augmentation of labor, P < 0.001 for both comparisons)(Table 3).
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).
Giving
birth by cesarean, or c - section, is on the rise in
hospitals as well as
among women who are choosing to give
birth via cesarean rather
than vaginally.
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 risk of all adverse maternal outcomes assessed was significantly lower
among the women who planned a home
birth than among those who planned a physician - attended
hospital birth (Table 3).
23 Therefore, the higher rate of admission (or readmission if a
hospital birth)
among newborns in the planned home -
birth group
than of readmission in the planned
hospital -
birth group may have been linked to the need for treatment of hyper - bilirubinemia, which,
among babies born in
hospital, may require a longer stay in
hospital rather
than readmission.
A University of Rochester - led study, published in the August issue of Health Affairs, shows complication rates can vary as much as five-fold
among hospitals, prompting researchers to call for the development of a national quality reporting system to improve maternal outcomes for more
than 4 million women who give
birth each year.
However, countries who have midwives as the leaders of maternity care and where home
birth is considered
among the norm experience better
birth outcomes
than countries where
birth is facilitated in
hospital settings with obstetricians.