Home Birth Imposes Higher Risks for First-Time Mothers

However, overall risk of perinatal adverse outcomes is low for all birth locations

MONDAY, Nov. 28 (HealthDay News) -- For healthy women with low-risk pregnancies, the incidence of adverse perinatal outcomes is low in all birth settings, giving these women more options when choosing where to have their baby, according to a study published online Nov. 24 in BMJ.

Peter Brocklehurst, from the University of Oxford in the United Kingdom, and colleagues compared perinatal and maternal outcomes for women with low-risk pregnancies, according to their planned place of birth (home, freestanding midwifery units, midwife-led obstetric units on a hospital site, and obstetric units) at the start of care in labor. A total of 64,538 eligible women with a singleton, term, and "booked" pregnancy, who gave birth between 2008 and 2010, were included in the analysis. The primary outcome, a composite of perinatal mortality and intrapartum-related neonatal morbidities, was used to compare outcomes by planned place of birth.

The investigators found that the overall weighted incidence was 4.3 per 1,000 births, and there were 250 primary outcome events. The adjusted odds of the primary outcome were not significantly different for any of the non-obstetric units, compared with obstetric units. The odds of the primary outcome were significantly increased for nulliparous women for planned home births (adjusted odds ratio, 1.75), but not for either midwifery unit setting. The incidence of the primary outcome did not differ significantly by planned place of birth in multiparous women. All non-obstetric unit settings had considerably lower interventions during labor. Compared to multiparous women, nulliparous women were more frequently transferred from non-obstetric unit settings (36 to 45 percent versus 9 to 13 percent).

"Adverse perinatal outcomes are uncommon in all settings," the authors write.

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