Home versus hospital birth--process and outcome

Area of Science:

• Perinatal outcomes research
• Maternal and infant health

Background:

• A small but significant number of American women opt for home delivery.
• Home birth is a controversial topic with polarized public and professional policies.
• Women choosing home birth often desire a non-medicalized experience with control in familiar surroundings.

Purpose of the Study:

• Assess perinatal outcomes of home births in developed countries.
• List advantages and disadvantages of planned home births.
• Identify limitations in current literature on home birth outcomes.

Main Methods:

• Literature review of perinatal outcomes associated with home births.
• Analysis of data on interventions and complications in home versus hospital births.
• Examination of newborn outcomes in various birth settings.

Main Results:

• Home births in developed nations are linked to increased perinatal and neonatal mortality, especially for non-anomalous term infants.
• Highly trained birth attendants integrated into healthcare systems may reduce cesareans, operative vaginal deliveries, episiotomies, and severe lacerations.
• Newborns from home births may experience fewer instances of meconium staining, assisted ventilation, low birth weight, prematurity, and NICU admissions.

Conclusions:

• Existing data highlight the need for further research into the safety of home birth in the United States.
• The benefits and risks of home birth require careful consideration, particularly regarding infant mortality and maternal interventions.
• Understanding confounders in current research is crucial for a comprehensive knowledge of home birth outcomes.