Friday, December 25, 2015

Are Home Births More Risky?

Forget the meat of the actual article here.  Just skip to the conclusion to find out that home births have a three times higher risk of neonatal morbidity.

Scrap home births.  They’re dangerous.  Less medical intervention means higher risk of death to the baby.

But wait!  When we read through the meat of this particular article we get a different picture.  Here’s what the authors found:

  • Planned home births had fewer maternal interventions (epidurals, electronic fetal heart rate monitoring, episiotomy, and operative delivery).
  • Women in planned home births were less likely to experience lacerations, hemorrhage, and infections.
  • Planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation.

So what gives?  How do we get these bad conclusions if some many good things were found in the study?  A few things to consider:

  • The number of actual deaths is very small (so if you triple a very small risk but protect against everything else the outcomes are overall much better).
  • If you read into the article itself, you find that the increased risk was all from one of the 12 studies looked at, and this particular study included preterm births and unplanned home deliveries, which do have an increased risk.

Talk about stacking the deck!!  So how could the one sentence conclusion be so derogatory considering the rest of the article??  Things that make you go “hmmm.”



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