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Perinatal outcome in hospital and birth center obstetric care
M David1, H K von Schwarzenfeld, J A Dimer
1Department of Obstetrics and Gynecology, Humboldt University School of Medicine, Berlin, Germany. matthias.david@charite.de
Objective:
Our purpose was to compare birth complications and fetal outcome in hospitals and birth centers.
Method:
We retrospectively compared all 801 deliveries between 1992 and 1994 from two free-standing birth centers against 3271 hospital deliveries in Berlin. The hospital collective was selected according to the same risk criteria of the birth centers.
Results:
The birth center group had significantly fewer medical interventions, with a similar cesarean section rate (3.0% vs. 4.6%, P = 0.057) and occurrence of severe perineal lesions. The episiotomy rate was significantly higher (P < 0.001) in the clinics for first-time and multiple births. The perinatal mortality was not significantly different ( < 0.1 per 1000). One-minute Apgar scores less than 7 were found significantly more often in the birth center group.
Conclusion:
When birth centers employ thorough risk selection and significant early referral rates to nearby hospitals, there is no evidence of increased maternal or perinatal risk compared to hospital deliveries.