National Institute for Clinical Excellence says homebirth has a higher rate of intrapartum death
Dr. Crippen alerts us to a report by the National Institute of Clinical Excellence in Britain that warns that homebirth has been shown to have a higher risk of intrapartum death:Birth outside a [physician] led unit is consistently associated with an increase in normal vaginal births, an increase in women with an intact perineum and an increase in maternal satisfaction. The quality of evidence available is not as good as it ought to be for such an important health care issue, and most studies have inherent bias. The evidence for standalone midwife led units and home births is of a particularly poor quality.This report confirms what I have said all along: There is no scientific evidence that homebirth is as safe as hospital birth and there is considerable evidence that homebirth leads to the deaths of babies during labor. Furthermore, just as I have said in the past, most homebirth studies are of poor quality and are inherently biased.
The only other feature of the studies comparing planned births outside [physician] units is a small difference in perinatal mortality that is very difficult to accurately quantify, but is potentially a clinically important trend. Our best broad estimate of the risk is an excess of between 1 death in a 1000 and 1 death in 5000 births. We would not have expected to see this, given that in some of the studies the planned hospital groups were a higher risk population.
Labels: neonatal mortality
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