Analysis Finds Risks With Midwife-Attended Home Births
Posted on: Wednesday, 6 May 2009, 06:14 CDT
New data released at a meeting of the Pediatric Academic Societies suggests that newborns face a higher risk of death when delivered at home attended by a certified nurse midwife than when born in hospitals with a certified nurse midwife in attendance.
"Currently, the only Western country with a substantial number of home births is the Netherlands, where 30 percent of births are in the home," a Reuters report quoted Dr. Michael H. Malloy of the University of Texas Medical Branch in Galveston as saying.
"In the U.S., less than 1 percent of births are in the home, and the American College of Obstetrics and Gynecology 'does not support programs that advocate for, or individuals who provide, home births'."
Malloy compared outcomes of nearly 12 million newborn babies by place of delivery and by type of delivery attendance over a recent 5-year time period. He limited his analysis to term babies delivered in the normal way.
"I decided to restrict the analysis to this low-risk population because they would be the best candidates for home delivery," he said.
The vast majority, 88.5 percent, of births took place in hospitals with a physician attending. The next most typical arrangement, at 10.6 percent, was hospital delivery with a certified nurse midwife in attendance.
Lagging far behind in popularity were hospital births with other nurse midwives births (0.2 percent), home births with a certified nurse midwife in attendance (0.1 percent), home delivery with other nurse midwives (0.4 percent) and birth-center deliveries with a certified nurse midwife attending (0.2 percent).
Although there were just 14 newborn deaths among babies delivered at home by a certified nurse midwife, this rate was more than double that for hospital deliveries attended by a certified nurse midwife. The rate was four-fold higher for home deliveries by other midwives, Malloy said.
The results show that the safest setting for the delivery of babies is in a hospital attended by a certified nurse midwife.
Women who deliver in the home "need to recognize the greater risk associated with that choice," said Malloy.
Malloy hypothesized that in-hospital deliveries attended by certified nurse midwives had lower mortality risks in his study than in-hospital physician deliveries because the physicians were delivering babies at higher risk.
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On the Net:
- Pediatric Academic Societies
- University of Texas Medical Branch in Galveston
- American College of Obstetrics and Gynecology
Source: redOrbit Staff & Wire Reports
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User Comments (2)
| 2. |
Posted by Rachel on 05/11/2009, 00:43 Martha - these are great questions. Reports like these do a disservice to the amazing work being performed by midwives, whether at homes or in birthing centers. |
| 1. |
Posted by Martha on 05/07/2009, 08:40 The phrase "He limited his analysis to term babies delivered in the normal way. " is very elusive. Does this include only babies born vaginally? Why aren't the numbers compared with doctors who also delivered low-risk babies "in the normal way". Why aren't they compared with doctors who do homebirths "in the normal way"? What about taking into account the distance from a hospital in the homebirths? how does this affect the outcomes? Printed in a US newsource is data about a birthing system in the Netherlands which doesn't necessarily equate to the very different US maternity system. I see no mention of these important concerns in the write up of this research. Kind of important, don't you think? |
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