Dive Brief:
- An study of 75,000 low-risk births between 2012 and 2013 published in the New England Journal of Medicine found out of every 1,000 deliveries planned at home or a birthing center, 3.9 babies died just before, during, or in the month after labor compared to 1.8 out of 1,000 babies died when births were planned for a hospital.
- However, Dr. Michael Greene, chief of obstetrics at Massachusetts General Hospital, wrote in an editorial accompanying the study, "The bottom line is, childbirth in the United States is very safe regardless of where you decide to do it."
- Close to 99% of women chose to deliver their babies in a hospital, but an increasing number are choosing to deliver them at home or a birthing center - up 30% from 2004 to 2009. This has raised issues about safety as well as midwife training and licensing and coordination between midwives and physicians.
Dive Insight:
Although the study showed an increased risk of death to a baby when planned for outside a hospital, there were some benefits. These include fewer cesarean deliveries (5.3% versus 24.7% in a hospital), fewer delivery interventions like drug-induced labor, and women were less likely to experience vaginal lacerations outside a hospital but more likely to require blood transfusions.
Dr. Aaron Caughey, one of the study authors, told NPR, "I think this is the best data we've had in our country on this question because where the woman intended to deliver really matters. It does support this idea that women are in some cases getting what they desire," he added. "They're getting this lower intervention rate in the out-of-hospital birth setting."
Steff Hedenkamp, a spokesperson for The Big Push for Midwives, described the study results, "pretty remarkable, given that in the United States midwives - certified professional midwives - are not integrated into many of our states' healthcare systems." The group is pushing more states to license midwives so physicians and midwives can better coordinate patient care to make deliveries outside hospitals safer.