Babies born out of the hospital are twice more likely to die than those born in a hospital, according to a new Oregon study published Thursday in the New England Journal of Medicine.

Even if out-of-hospital births are planned, babies are at a higher risk of death. Whilst 3-9 of every 1,000 babies born at home or in a residential-style birthing center die, only 1.8 of every 1,000 deliveries occurred in a hospital end in perinatal death.

Newborn babies (0-3 months) in hospital nursery. Credit: The Huffington Post
Newborn babies (0-3 months) in hospital nursery. Credit: The Huffington Post

Lead author and epidemiologist Jonathan Snowden from Oregon Health & Science University along with his team analyzed all births occurred in the state in 2012 and 2013. Oregon was an ideal state to study because it had the highest rate of home births nationwide in 2012, at 2.4%, whereas 1.6% of the babies were born in birthing centers. Moreover, in that same year the state adopted a new birth certificate that asked mothers where they had planned to give birth, not only where their last deliveries had occurred.

Researchers found that the Oregon mother who reported their wish to give birth at home or in a birthing center were more likely to be older and have better health conditions than women who attempted to deliver in a hospital. Besides, they tended to be white and to be able to cover their medical costs by themselves or to have private insurance.

The study findings also revealed that when deliveries were planned to occur out of a hospital, babies tended to suffer seizures and were more likely to need a ventilator to help them breathe. Moreover, newborns were also more likely to have a 5-minute Apgar score below 7 five minutes after delivery. That sign means that the baby requires urgent medical attention.

According to the National Center for Health Statistics, in 2014 over 59,000 babies were born outside hospitals, which equates to 1.5% of all births in the United States that year. About two-thirds of those babies were born at home, marking the highest number since 1989. The majority of the rest births occurred in birthing centers.

Study authors concluded that each mother is responsible for comparing the benefits of planning an out-of-hospital birth against the benefits of having their babies in a hospital. While the first choice offers a more comfortable environment and fewer invasive medical procedures, the last one involves available emergency services in case they are required. When making a decision, researchers recommend keeping in mind that “serious adverse fetal neonatal outcomes are infrequent in all birth settings”, even when out-of-hospital deliveries are more risky.

Source: Los Angeles Times