Thursday, July 1, 2010

International study claims triple neo-natal death risk for homebirths

The Age, Thurs 1 July, 2010
"Home birth triples neo-natal death risk: study"

The study in the American Journal of Obstetrics and Gynaecology will inflame passions. But, say the researchers from Maine Medical Centre in Portland, the findings must be addressed. "Women, particularly low-risk parous [having given birth before] individuals, choosing home birth are in large part successful in achieving their goal of delivering with less morbidity [damage] and medical intervention than experienced during hospital-based childbirth," they write.

"Of significant concern, these apparent benefits are associated with a near tripling of the neonatal mortality rate among nonanomalous [without birth defects] infants."

The researchers pulled together data from studies in the US and in Europe. They considered a total of 342,056 planned home births and 207,551 planned hospital births.

The increased death rate was in neonates - babies in the four weeks after delivery. The team found double the number of deaths overall among those born at home and triple the number when they removed those with congenital defects from the calculation. The main causes were breathing problems during birth and failed resuscitation after delivery.

The Globe and Mail, Wed 30 Jun, 2010
"U.S. analysis on home birth risks seen as deeply flawed"

Patricia Janssen, an associate professor at the University of British Columbia’s school of population and public health, says that conclusion is “sensationalist” and based on data that are in some cases decades old, on very small samples and in some cases incomplete.

In many cases, she says, women included in the studies may not have planned to give birth at home. They may not have been attended by a properly trained midwife. And much of the data used were retrospectively, gathered using birth records, which may not include enough information.

Dr. Janssen’s most recent research, published last September, found no difference in outcomes between planned hospital births and planned home births. Similar results were found in an Ontario study.

MIDIRS: Midwives Information Resource Services, Thurs 1 July, 2010
"Home births in UK safe say midwives"

Commenting on the research on ‘maternal and newborn outcomes in planned home birth versus planned hospital births’ in the American Journal of Obstetrics & Gynecology, Mervi Jokinen, Practice and Standards Development Advisor at the Royal College of Midwives, said: “It is certainly a study that will generate discussion around home births, and is important in adding to the body of evidence around this.

“Whilst it is interesting, I do question the validity of its findings for the UK. Comparison of the results is difficult because the study’s authors are working with data collected differently in many countries.

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