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Study Shows Adverse Outcomes In High Risk Home Births

A study of home births in Oregon showed an increased rate of death in infants transferred to the hospital due to problems during the delivery.

However all adverse outcomes were associated with high risk pregnancies. The five-year study confirms previous research showing that there are significant and serious risks for high risk pregnancies and home birth.

Researchers looked at data from 223 home birth hospital transfers in Oregon between 2004-2008. Out of the 223 hospital transfers, eight babies died. Of the group, four mothers had preeclampsia, three babies were breech, and two delivered after 42 weeks. Of the eight deaths, one of the babies had congenital abnormalities “not compatible with life.” All but one birth took place with the assistance of a licensed midwife.

“Our study showed that each of the neonatal deaths had higher . . . risk conditions associated, such as breech, hypertensive disorders, meconium [first intestinal discharge of newborns], postdates and/or anomaly. More data is needed to examine how pregnant women with these conditions are managed out of hospital, if there is evidence to support women with these conditions having out of hospital births, and what the barriers are for hospital transport,” said lead researcher, Dr. Stella Dantas.

Speaking to USNews.com, Dr. Mary Norton, director of perinatal research at Stanford University Medical Center, commented that “For most healthy women, childbirth is a safe, low-risk procedure and for many women, it can safely happen at home. But there are times when things go wrong, and they can be hard to anticipate, and they are much more common when there is a high-risk situation, such as high blood pressure, preeclampsia, breech and being postdate.

As far as the births examined in this specific study, she noted “They were all very high-risk conditions and not patients that should have been delivering at home.”

The American College of Obstetricians and Gynecologists does not support home birth but their position is controversial. In the UK, both the Royal College of Midwives and the Royal College of Obstetricians and Gynecologists support home births with uncomplicated pregnancies. A recent study out of the UK indicates that home birth for second babies and low-risk pregnancies are as safe as hospital birth.

The study will be presented at the American College of Obstetricians and Gynecologists (ACOG) annual meeting in San Diego. It has not yet been peer-reviewed.

photo credit: Flickr/Davhor

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