What fetal outcomes have been reported for midwife-attended home labor and delivery?

Updated: Jan 24, 2019
  • Author: Sarah Hagood Milton, MD; Chief Editor: Christine Isaacs, MD  more...
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However, concerns about the effect of midwife-attended home births on neonatal health were raised by an analysis of nearly 14 million singleton, full-term births, from 2007-2010, of infants of normal weight. The data, from the National Center for Health Statistics, indicated that delivering at home was associated with a greater than 10-fold increased risk for an Apgar score of 0 and a nearly 4-fold increased risk for neonatal seizure or serious neurologic dysfunction, as compared with hospital delivery. [28, 29]

Compared with delivery by a hospital physician, midwife-attended home birth was associated with a relative risk (RR) of 10.55 for an Apgar score of 0. For midwife deliveries at freestanding birth centers, the RR was 3.56, and for hospital midwife deliveries, the RR was 0.55. [28, 29]

In the same study, the RR for neonatal seizures or serious neurologic disorders for midwife-attended home births, compared with physician-attended hospital delivery, was 3.80. Compared with in-hospital physician delivery, the RR for midwife delivery at freestanding birth centers was 1.88, and for hospital midwife delivery, the RR was 0.74. [28, 29]

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