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Home birth complications ‘less common’ than hospital

Planned home births are less risky than planned hospital births, particularly for second-time mothers, says research in the British Medical Journal.
A large Dutch study found the risk of severe complications to be one in 1,000 for home births and 2.3 in 1,000 for hospital births.
The Royal College of Midwives said the study was further evidence of the safety and benefits of home birth.
For low-risk women having their first baby at home, the study calculated their risk of being admitted to intensive care or needing a large blood transfusion to be small - and similar to women giving birth in hospital.
This was 2.3 per 1,000 for home births, compared with 3.1 per 1,000 for planned hospital births.
But in women who had given birth before, severe complications were found to be less common during planned home births.
The researchers, including midwives and obstetricians from universities in Amsterdam, Leiden and Nijmegen, said those figures were “statistically significant”.
In this group of women, the risk of severe blood loss after delivery (also known as postpartum haemorrhage) was 19.6 per 1,000 for a planned home birth compared with 37.6 per 1,000 for planned hospital births.
In the study of nearly 150,000 low-risk women in the Netherlands who gave birth between 2004 and 2006, 92,333 had a planned home birth and 54,419 had a planned hospital birth.
Ank de Jonge, a practising midwife and senior researcher on the study from the VU University Medical Centre in Amsterdam, said their findings showed that the system in the Netherlands was working well.
But she emphasised that this depended on a number of different factors.
“This comes from a good risk selection system, good transport in place and well-trained midwives.”
She also warned that in emergencies the right facilities had to be in place.
“Women who give birth at home are less likely to have interventions at home, but if there is a serious problem there should be a good system to deal with them.”
The study said, “Every avoidable adverse maternal outcome is one too many,” and should lead to improvements in maternity care.



Source: BBC Health