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Home birth babies more at risk

5th July 2010

Home births lead to a faster recovery after childbirth, but carry a higher risk that the baby will die, a new study has shown.

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Researchers in the United States analysed more than 500,000 births in North America and Europe, and found that death rates for babies in planned home births were twice as high for those in planned hospital births.

However, the risk of death was still low, they said, citing a death rate of 0.2% risk for planned home births.

However, a body of midwives has questioned the relevance of the report to women's decisions about how to give birth.

Published in the American Journal of Obstetrics and Gynaecology, the study looked at data on the relative safety of planned home and hospital births.

They scanned records of more than 200,000 planned hospital deliveries and nearly 350,000 planned home births.

The study focused on where the mothers had planned to have their babies, rather than on where they actually ended up having them.

They did this to factor in home births that resulted in the mother being rushed to hospital during the birth with complications, which were then recorded as hospital births.

Around one in three women in the Netherlands choose to give birth at home, while only one in 200 US women do so.

The researchers said their finding, that the neonatal mortality rate doubled in planned home births, was 'striking'.

Nearly all the home births that resulted in the death of the baby, when no congenital abnormalities were present, were the result of failed attempts to resuscitate the infant after it had trouble breathing.

Such problems are thought to be more easily averted with the use of ultrasound, foetal monitoring, induction of labour and Caesarian sections.

Mervi Jokinen, spokeswoman for the Royal College of Midwives, said the researchers did not focus on the possible link between the lack of medical intervention and the lower incidence of tears or lacerations, postpartum haemorrhage and fewer infections.

The researchers did say, however, that women choosing home birth, particularly low-risk individuals who had given birth previously, were in large part successful in achieving their goal of delivering with less morbidity and medical intervention than would be possible with a hospital-based childbirth.

Lead author Joseph Wax from the Department of Obstetrics and Gynaecology at Maine Medical Center said it was 'of significant concern' that such apparent benefits were associated with a doubling of the neonatal mortality rate overall and a near tripling among infants born without congenital defects.


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