Monday, June 19, 2006

Homebirth: death during labor

When comparing homebirth to hospital birth, we are comparing more than place of birth. Most women choosing homebirth are cared for by DEMs or CNMs and the quality of prenatal care may also contribute to the outcomes.

What happens when you look at only the place of birth? The best way to capture that would be to look at the death rates in labor. In other words, if you start labor with a live baby, what are the chances of the baby surviving labor? It turns out that the chances of surviving labor are dramatically higher in the hospital.

The chance of your baby dying in labor in a hospital is extremely low. Published studies indicate that the intrapartum death rate is in the range of 1-2/10,000 births.

Let's look at the death rates in labor for the 4 most widely quoted studies of homebirth:

Murphy & Fullerton 2/1221 = 16/10,000

Johnson & Daviss 5/5418 = 9.2/10,000

Janssen 1/860 = 12/10,000

Northern Region 5/2888 = 17/10,000

In other words, if you start labor with a live baby, the chance of that baby dying in labor is 10 times higher if you labor at home as opposed to in a hospital.


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