Sunday 23 July 2017

Home birth increases death risk for baby

Jane Kirby in London

Babies born to first-time mothers who choose a home birth are almost three times more likely to die or suffer a medical complication, according to a report.

The Birthplace in England study found these babies were 2.8 times more likely to suffer serious problems compared with those born in hospital obstetric units.

Problems include stillbirth after the start of labour, the baby dying within the first week of birth, brain injury, fractures to the upper arm or shoulder during birth, and faeces in the lung.

Conditions can vary in severity and long-term impact but are linked to trauma at birth or the baby becoming distressed or being deprived of oxygen.

There was no increased risk for babies whose births were planned at units led by midwives, either ones that stand alone in the community or which are attached to a hospital.

There was also no increased risk for second or subsequent babies whose mothers planned a home birth.

Serious adverse outcomes for the baby are rare -- occurring just 3.5 times for every 1,000 babies whose birth was planned in an obstetric unit.

But the research, carried out at Oxford University, shows this figure rises to 9.5 per 1,000 babies if the mother chooses a home birth.

These figures relate to women who have had a low-risk pregnancy and who did not have any complications at the start of labour.

The study compared data for almost 65,000 women at low risk of complications who planned to give birth in obstetric units, at home or at a midwife-led unit.

The researchers stressed that giving birth is generally very safe.

For the entire group of women studied, 250 babies suffered an adverse outcome.

The researchers did find women had a higher chance of intervention -- such as caesarean, ventouse or forceps delivery -- if they chose an obstetric unit.

Only 58pc of these women had a natural birth without any intervention, compared with 88pc of women who opted for a home birth and 76pc to 83pc of women who chose a midwife-led unit.

Around nine out of 10 births occur in hospital obstetric units, with only 4pc of births planned at home. Just over a quarter of those wanting a home birth are first-time mothers.

The report also found women were frequently transferred to hospital from midwife-led units and from home -- with 21pc to 26pc of all women transferred. This rose to 36pc to 45pc of first-time mothers.

Uncommon

The research was published in the 'British Medical Journal'.

Professor Peter Brocklehurst, who led the study and now works at University College London, said adverse events were very uncommon.

He added: "These results should reassure women planning their birth that they can make decisions about where they'd like the birth to happen, knowing that giving birth in England is generally very safe."

Royal College of Midwives chief executive and general secretary Cathy Warwick said: "This study demonstrates clearly the safety of midwife-led care."

She added: "A woman having her first baby needs to be aware that whilst the vast majority of babies will be well, there is a chance that the baby may have a poor outcome and at home this chance is slightly increased."

Irish Independent

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