Mortality more than doubles for out-of-hospital births

The mortality rate for babies whose mothers intentionally gave birth outside of hospitals was more than double the rate of planned in-hospital births, a new study showed. But the researchers also noted the risk of death was low in both settings.

The mortality rate was 3.9 deaths per 1,000 deliveries for out-of-hospital births, compared with 1.8 per 1,000 for in-hospital births, according to the study published online in the New England Journal of Medicine. The study also found that babies were more likely to suffer seizures following planned out-of-hospital births, but less likely to be admitted to a neonatal intensive care unit.

Reuters Health, in a report on the findings, noted that the results differed from a larger Canadian study that found no difference in perinatal death rates among women giving birth at home. The authors of both studies told the news agency that the results probably varied because of underlying differences in Ontario, Canada, and in Oregon, where the newer study was conducted.

The chief author of the Oregon study told Reuters that the Canadian healthcare system has regulations determining whether women can safety give birth outside of hospitals.

While 99 percent of U.S. women give birth in hospitals, the number of women delivering at home or in a birthing center increased nearly 30 percent between 2004 and 2009, NPR noted in an article about the study findings. The research reviewed more than 75,000 low-risk births in Oregon in 2012 and 2013.

"The bottom line is, childbirth in the United States is very safe regardless of where you decide to do it," Michael Greene, M.D., head of obstetrics at the Massachusetts General Hospital in Boston, told NPR. Greene co-authored an opinion piece about the topic that accompanied the study.

Other healthcare professionals continue to push for hospital births. Obstetrician Amy Tuteur, M.D., for example, warned that the rate of complications such as anoxic brain injuries are far higher in home births.

But another Canadian study found that planned home births saved couples an average of $1,806 in U.S. dollars compared with midwife-supervised hospital births, and $1,922 for doctor-supervised hospital births.

To learn more:
- here's the study abstract and the commentary
- see the Reuters Health article
- check out the NPR article