[The problem of domiciliary obstetric practice (author's transl)]

From a group of 8,020 well-documented and electronically recorded deliveries at the Tübingen University Gynaecological Clinic during 1976-1979 we selected 1147 (14.3%) according to strict criteria and subjected them to further analysis. These 1147 pregnant women had one feature in common, namely, that there were absolutely no signs of any risk factor prior to delivery (Table 1).

83% only of these children were delivered spontaneously; in 0.8% of the cases it was necessary to effect Caesarean section, and in another 15% vaginal-surgical delivery proved necessary. In 10% threatening and in 0.9% acute foetal asphyxia was the guiding sign for appropriate obstetric measures. In 31.4% of the cases we found a twisted cord, whereas the frequency rate of acidosis (pHNA less than 7100) was 7%. Apgar counts below 7 were seen in 2.3% and indices below 3 in 0.1% of the cases. Perinatal mortality was approximately 1:1000. Complications requiring follow-ups were seen in the first week post partum in every 20th child. It is concluded that domiciliary obstetric practice cannot be medically recommended since it involves a risk rate for both mother and child which is considered too high.