Newborn Mortality Higher with Midwives at Home than with Midwives in the Hospital
In an article published online in the American Journal of Obstetrics & Gynecology (March 24, 2014), the authors examined newborn mortality in relation to birth settings and birth attendants in the United States from 2006-2009. Using data from the CDC linking birth outcomes with setting (in hospital, in birth center, or at home) and with provider (physician, hospital-based midwife, home-based midwife, and “others” at home) in almost 14 million births and using hospital-based midwives as the reference, the authors found that newborn mortality was almost four times greater for midwife home births than for midwife hospital births. After 41 weeks and for first-time mothers, the difference was even greater. Early mortality for midwife home births compared to midwife hospital births was almost seven times higher. Hospital physicians also had a higher rate of newborn mortality than hospital midwives, but the authors attributed this difference to the fact that obstetricians see higher-risk women than midwives, and care for high-risk women referred by midwives.
Grunebaum A, Mcullough LB, Sapra KJ, Brent RL, Levene ML, Arabin B, Chervenak FA. Early and Total Neonatal Mortality in Relation to Birth Setting in the United States, 2006-2009. American Journal of Obstetrics & Gynecology, accepted manuscript.
To read more about this study, go to the Medscape article at http://www.medscape.com/viewarticle/823091?nlid=53626_785&src=wnl_edit_medp_nurs&uac=868FN&spon=24
To read the abstract, go to http://www.ajog.org/article/S0002-9378%2814%2900275-0/abstract