Home births linked to higher neonatal mortality rate

Compared with planned hospital births, planned home births are associated with fewer maternal interventions such as operative delivery, episiotomy, epidural analgesia, and electronic fetal heart rate monitoring.

Planned home births are also associated with fewer maternal lacerations, hemorrhage, and infections and with lower incidences of prematurity, low birth weight, and assisted newborn ventilation.

Home births are also associated with an almost twice-as-high overall neonatal death rate and an almost tripled mortality rate among nonanomalous neonates, according to the findings of a recent meta-analysis of English-language, peer-reviewed publications from developed Western nations.

Investigators found that the high mortality rates may be attributed to inadequate resuscitation in the home environment for neonates experiencing intrapartum anoxia or asphyxia.

No significant difference between environments in the perinatal mortality rate was found, and no maternal deaths were reported to have occurred in either environment.

Wax JR, Lucas FL, Lamont M, Pinette MG, Cartin A, Blackstone J. Maternal and newborn outcomes in planned home birth vs planned hospital births: a meta-analysis. Am J Obstet Gynecol. In press.