Home birth poses danger for higher-risk pregnancies: study

May 8, 2012 By Jenifer Goodwin, HealthDay Reporter
Home birth poses danger for higher-Risk pregnancies: study
Researchers looked at infant death rates in Oregon.

(HealthDay) -- A five-year study of home births in Oregon found an elevated rate of deaths among babies that had to be transferred to the hospital because something went wrong during the delivery.

However, experts said this doesn't necessarily mean that home births are dangerous. Many of the babies and mothers had conditions that put them at higher risk of complications, such as preeclampsia ( during birth) or breech position (when the baby is feet first instead of head first).

The researchers looked at on 223 home births in Oregon from 2004 to 2008, in which the babies were transferred to a hospital because of problems during or right after delivery. Eight babies died, according to the study to be presented Tuesday at the American College of Obstetricians and Gynecologists (ACOG) annual meeting in San Diego.

Three of the babies were in the breech position; four of the mothers had preeclampsia; and two mothers delivered postdate, usually defined as a pregnancy of 42 weeks or longer (40 weeks is generally considered full-term).

Of the eight deaths, one infant had "not compatible with life," Dr. Stella Dantas, of the department of at Northwest Permanente, P.C. Physicians and Surgeons in Beaverton, Ore., and colleagues noted in an ACOG news release. All of the women except one were assisted by a licensed .

"Our study showed that each of the had higher . . . risk conditions associated, such as breech, hypertensive disorders, meconium [first intestinal discharge of ], 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 , and what the barriers are for hospital transport," Dantas said.

Nearly 30,000 women gave birth at home in the in 2009, according to the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

Though still accounting for less than 1 percent of all births, home births in the United States increased by 29 percent between 2004 and 2009.

Home births in the United States tend to be more common among white women -- one in 90 births was a home birth -- but less likely among other racial and ethnic groups, CDC statistics show.

In addition, the popularity of home births varies among the states. Montana has the highest percentage of , at nearly 2.6 percent, followed by Oregon and Vermont, with nearly 2 percent each.

Women who opt to at home often object to turning a natural process into a medical problem in need of doctors and hospitals, said Dr. Mary Norton, director of perinatal research at Stanford University Medical Center.

Some women want to give birth without painkillers such as epidurals, Norton said. They may want to have "more control" over the birth experience; may feel more comfortable in their own surroundings; or may want to have multiple people in the room when they deliver, something many hospitals limit, Norton added.

"There is a small percentage of women who feel very strongly they don't want all the accoutrements of delivering in the hospital, and they have enough distrust of the medical system that their best option is to deliver at home," Norton said.

While many women can give birth at home safely, women choosing home birth should recognize there are risks, Norton said.

"For most healthy women, childbirth is a safe, low-risk procedure and for many women, it can safely happen at home," Norton said. "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."

Whereas birthing centers often have systems in place to transfer a woman to a hospital in case of emergency, women at home may have to wait longer for an ambulance, or it may be difficult to move a woman who is in labor onto a gurney and transport her to a hospital.

In the Oregon deaths, it's unknown if the women knew about the conditions prior to deciding to give birth at home, or if the problems arose during labor. Either way, these should have been in a hospital, Norton said.

"They were all very high-risk conditions and not patients that should have been delivering at home," Norton said.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Explore further: Study weighs risks and benefits of birthing facilities

More information: The American Pregnancy Association has more on home births.

Related Stories

Study weighs risks and benefits of birthing facilities

February 10, 2012
In a study to be presented today at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that indicate that the risk of obstetric intervention ...

US home births increase 20 percent from 2004 to 2008

May 20, 2011
After a gradual decline from 1990 to 2004, a new study published online in Birth: Issues in Perinatal Care finds that United States births occurring at home increased by 20 percent between 2004 and 2008.

Births at home and in midwifery units could signify cost savings for the NHS

April 20, 2012
Giving women who have previously given birth and who are at low risk of complications the opportunity to give birth at home or in a midwifery unit saves the NHS money, is safe for the baby and improves outcomes for the mother, ...

Midwives use rituals to send message that women's bodies know best

December 16, 2011
In reaction to what midwives view as the overly medicalized way hospitals deliver babies, they have created birthing rituals to send the message that women's bodies know best.

Recommended for you

Hormone from fat tissue can give protection against polycystic ovary syndrome

August 10, 2017
Obesity and reduced insulin sensitivity are common in polycystic ovary syndrome, PCOS. New research based on animal studies, and to be published in the journal PNAS, reveals that the hormone adiponectin can protect against ...

Study in mice may reveal insights into causes of miscarriages for some women

August 9, 2017
Researchers at St. Michael's Hospital have identified how natural killer cells in the mouse placenta can cause a fetus to fail to grow in the womb or cause miscarriages.

Insomnia, sleep apnea nearly double the risk of preterm delivery before 34 weeks

August 9, 2017
Pregnant women who are diagnosed with sleep disorders such as sleep apnea and insomnia appear to be at risk of delivering their babies before reaching full term, according to an analysis of California births by researchers ...

Elective freezing of IVF embryos linked to higher pregnancy rates in some cases

August 1, 2017
A delay in transferring embryos to the mother improves the success of in vitro fertilization in certain cases, according to a study by scientists at the Stanford University School of Medicine, Celmatix Inc. and several other ...

Negative birth outcomes linked to air pollution exposure early in pregnancy, study finds

July 27, 2017
Exposure to air pollution early in a pregnancy could increase risk for preterm birth and low birth weight, according to a study led by researchers at NYU School of Medicine, and published on July 27 in Environmental Health ...

Study shows a significant ongoing decline in sperm counts of Western men

July 25, 2017
In the first systematic review and meta-analysis of trends in sperm count, researchers from the Hebrew University-Hadassah Braun School of Public Health and Community Medicine and the Icahn School of Medicine at Mount Sinai ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.