Maternal and Newborn Outcomes in Planned Homebirth vs Planned Hospital Births: A Meta-analysis

Bottom Line: Homebirth has triple the neonatal mortality rate when compared with hospital birth.

Wax, et. al.

The objective of this study was to systematically review the medical literature on the maternal and newborn safety of planned home vs planned hospital birth. English-language peer-reviewed publications from developed Western nations were included.

RESULTS: Planned home births were associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birth weight, and assisted newborn ventilation. Although planned home and hospital births exhibited similar perinatal mortality rates, planned home births were associated with significantly elevated neonatal mortality rates.

CONCLUSION: Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate.

CLINICAL IMPLICATIONS

  • Planned home birth is associated with a tripling of the neonatal mortality rate.
  • Lower obstetric risk among women choosing home birth is likely to overestimate associated benefits and underestimate risks of this delivery choice.