In the largest study of its kind, investigators at New York-Presbyterian/Weill Cornell Medical Center in New York City reviewed data from a sampling of 13 million of the nearly 17 million singleton full-term births in the United States between 2004-2007. These included births to parents of all races, ethnic groups and income levels.
Among their findings: Babies born at home were nearly 10 times more likely to be stillborn, and the risk of stillbirth increased to 14 times for firstborns. Babies born at home were also almost four times more likely to experience neonatal seizures or serious neurologic dysfunction compared with babies born in hospitals.
The study's results were confirmed by analyzing birth certificate files from the National Center for Health Statistics to evaluate deliveries by physicians and midwives in the hospital and at home from 2007 to 2010. The researchers looked at Apgars, scores that assess the health of an infant one minute and five minutes after birth. A five-minute Apgar score of zero is considered a stillbirth. About 10 percent of these babies survive, though often with major health problems.
"Childbirth is one of the most wonderful moments in humanity, and people deserve the best of all circumstances, including enhancing the experience and reducing unnecessary interventions," said Dr. Amos Grunebaum, chief of labor and delivery at New York-Presbyterian/Weill Cornell Medical Center, and the study's lead author. "Having said that, it's not only about experience. It's also about making sure the baby is born safely."
Grunebaum said that the study associated risk with the location of a planned birth, rather than the credentials of the person delivering the baby. When a child is born at home, typically there is only the midwife or doctor to address any unpredictable circumstances that arise, but in the hospital, a team of specialists can be mobilized in seconds if needed, he said.