Research

CDC Data Shows Neonatal Mortality Rate 7.7 times Higher 

The  Centers for Disease Control has recently released data for 2007 that shows homebirth with a non-nurse midwife has a neonatal mortality rate 7.7 times higher than comparable risk hospital birth. The data for 2003-2004 shows homebirth neonatal mortality 3 times higher. The extraordinarily high death rate actually under-counts the homebirth death rate because many homebirth transfers ended up in the hospital MD group and were not counted in the homebirth group. The real number of homebirth deaths is almost certainly significantly higher.

Neonatal Mortality Rate (0-27days) per 1000 live births 2007)

Attendant                                         Births                                  Deaths                                Mortality Rate

CNM                                                   128,929                              44                                         0.34

MD                                                      1,540,056                           884                                      0.57

DEM                                                   12,214                                 32                                         2.62

(White women, 37+ weeks, 2500+ gm, ages 20-45)

To search the CDC site click her:  http://wonder.cdc.gov/lbd.html

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Statistics Released Showing Horrific Number of Infant Home Deaths

In 2009 Colorado licensed midwives provided care for 799 women. Nine (9) babies died for a homebirth death rate of 11.3/1000! That is nearly DOUBLE the perinatal death rate of 6.3/1000 for the entire state (including all pregnancy complications and premature births). The perinatal death rate of LICENSED homebirth midwives in Colorado, caring for low risk patients, has exceeded the perinatal death rate in Colorado every year since it began licensing midwives in 2006.

Year              Patients at  Start of Labor                  Perinatal Deaths                      Perinatal Mortality Rate

2006            642                                                                    5                                              7.8 / 1000

2007            696                                                                    5                                              7.2/ 1000

2008            806                                                                    7                                               8.6/ 1000

2009            799                                                                    9                                              11.3/1000

The data was gathered by the midwives themselves, and involved only planned homebirth with midwives licensed by the state of Colorado. The death rates are appalling. The midwives (in violation of the law) have refused to release the data for 2010.

http://www.dora.state.co.us/midwives/Newsletter2007.pdf

http://www.dora.state.co.us/midwives/Newsletter2008.pdf

http://www.dora.state.co.us/midwives/Newsletter2009.pdf

http://www.dora.state.co.us/midwives/Newsletter2010.pdf

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HOMEBIRTH DEATH STATISTICS

“Homebirth Death Statistics has been created as a repository for the scientific papers, state, national and international statistics on the increased risk of death at homebirth.”

To read more click here: http://homebirthdeathstatistics.blogspot.com/2012/07/homebirth-with-cnm-vs-non-nurse-midwife.html

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Outcomes of planned home births in Washington State: 1989-1996

Pang JW, Heffelfinger JD, Huang GJ, Benedetti TJ, Weiss NS.

Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington 98195, USA. jwpang@u.washington.edu

“…RESULTS: Infants of planned home deliveries were at increased risk of neonatal death (adjusted relative risk [RR] 1.99, 95% confidence interval [CI] 1.06, 3.73), and Apgar score no higher than 3 at 5 minutes (RR 2.31, 95% CI 1.29, 4.16). These same relationships remained when the analysis was restricted to pregnancies of at least 37 weeks’ gestation. Among nulliparous women only, these deliveries also were associated with an increased risk of prolonged labor (RR 1.73, 95% CI 1.28, 2.34) and postpartum bleeding (RR 2.76, 95% CI 1.74, 4.36).”

“CONCLUSION: This study suggests that planned home births in Washington State during 1989-1996 had greater infant and maternal risks than did hospital births.”…

To read the entire article click here: http://www.ncbi.nlm.nih.gov/pubmed/12151146

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Birth Outcomes of Planned Home Births in Missouri: A Population-Based Study

by Chang and Macones published in the American Journal of Perinatology in August 2011 is notable for careful methodology.

…”Our analysis demonstrates cause of concern about safety of planned home births attended by non-CNMs and physician/CNMs. The results of our study suggest that planned home births are associated with increased likelihood of intrapartum fetal death and newborn seizures, despite the fact that the lowest risk women choose this birthing option”…

To read the entire study click Missouri study

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Health of Mothers, Babies May Be Compromised In Planned Home Births

“….Compared with women who plan to have their baby delivered in a hospital, women who intend to have their baby delivered by a professional provider at home have a greater likelihood of complications during and after labor and delivery, and their newborn has an increased risk of compromised health. In particular, newborns of women who planned a home delivery are twice as likely to have a very low Apgar score or to die as are newborns of women who planned a hospital delivery, according to a retrospective analysis of births in Washington State from 1989 to 1996. Moreover, among previously nulliparous women, planned home birth is associated with elevated risks for prolonged labor and postpartum bleeding. As the analysts comment, these findings are important to consider, given the increased popularity of out-of-hospital births in recent years…”

To read the entire article click here: http://www.guttmacher.org/pubs/journals/3432002.html

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Less Medical Intervention for Home Birth Linked to Increased Neonatal Mortality Rate CME/CE

News Author: Laurie Barclay, MD CME Author: Hien T. Nghiem, MD

“…July 6, 2010 — Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate vs planned hospital birth, according to the results of a systematic review and meta-analysis reported online first July 1 and will appear in the September 10 print issue of the American Journal of Obstetrics & Gynecology.”

“Perinatal mortality rates were similar for planned home and hospital births, but neonatal mortality rates were significantly higher with planned home births.”

“Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate,” the study authors write…”

To read entire article click here: Less Medical Intervention For Homebirth Linked to Increased Neonatal Mortality

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Infant Outcomes of Certified Nurse Midwife Attended Home Births:United States 2000 to 2004

“..Conclusion: Deliveries at home attended by CNMs and ‘other midwives’ were associated with higher risks for mortality than deliveries in-hospital by CNMs.”

To read entire article click here:

http://illinoisaap.org/wp-content/uploads/Outcomes-of-midwifery.pdf

 

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