Planned Home Births Increased Risk Of Death

Posted: Dec 31 2015, 5:11am CST | by , in News | Latest Science News

 
Planned Home Births Increased Risk of Death
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  • Planned Out-of-Hospital Births Increase Risk of Perinatal Death

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It has been found that giving birth at home or at a hospital each has its own individual risks.

Birth is a complicated procedure, one that requires intensive care methods. And whether you give birth at your residence via the services of a midwife or at a hospital, the risk factors are about equal.

But they differ in kind. At-home births carried a higher risk of perinatal death. As for treatment at a hospital, it involved cesarean delivery complications and obstetric mix-ups. The study is meant to augment the national dialogue on maternal care and health services.

More women need the serious attention of doctors, nurses and healers. Females in Oregon are more likely to give birth to healthy babies with few glitches in the childbirth process. And this counts in any milieu, be it that of a hospital or a home.

The deliveries are normal vaginal births. Although there is a small risk of adverse circumstances occurring, the chances are so small as to be almost irrelevant. The study was conducted on moms and babies and the data was collected from birth certificates collected a few years ago.

"This study continues the national dialogue about the care, setting and health care systems that can provide more women with a safe, healthy birth that meets their birthing preferences," said Jonathan M. Snowden, Ph.D., an epidemiologist and assistant professor in the Department of Obstetrics and Gynecology in the OHSU School of Medicine and lead author of the study.

"Our findings show that Oregon women are very likely to have a safe delivery in any setting. While those who deliver at home or in birth centers are much more likely to have a normal, vaginal delivery, there is also a small but statistically significant increase in risk for adverse baby outcomes."

When mothers-to-be went into the labor pains, the setting was important. Among the low risk pregnancies were those babies who had their heads down, were close to being born and weren’t twins or multiple births.

Risks were low but at the same time the chances of some complications arising were there. The law of chance could not be ruled out entirely. Women ought to be well-informed regarding the minimax equation (minimum costs and maximum benefits) related to childbirth. Hospital births had a higher chance of perinatal deaths. Neonatal seizures were a rarity in all settings.

"While the overall risk for perinatal death was low in all settings, the stakes can be high," said Aaron B. Caughey, M.D., Ph.D., professor and chair in the OHSU Department of Obstetrics and Gynecology, associate dean for Women's Health Research and Policy in the OHSU School of Medicine, and paper co-author.

"As health care providers, we need to make sure women know what the trade-offs are so they can make an informed choice that reflects their birth preferences."

Cesarean sections were common in hospitals. Outside the hospital, emergency requirement of blood transfusions were more likely to be the norm. Very few obstetric interventions were necessary outside a hospital setting.

In hospitals, mothers-to-be who suffered from hypertension, diabetes and previous C-sections were more likely to be at risk. This was the first such study that brought out the contradictory elements of home/hospital births.

It seems both procedures are a mixed bag of benefits and risks. While prehistorically and even for 99% of our history, birth was an at-home affair, nowadays most women prefer the hospital as a venue for delivery. The greater care and antiseptic atmosphere appeal to modern mothers-to-be.

The findings of this study published today in the New England Journal of Medicine by researchers at Oregon Health & Science University.

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