Where Women Give Birth Matters

Birthing centers and hospitals safer than home births for babies

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) While C section rates are lower among women who deliver away from the hospital, there were significantly higher complications associated with women choosing to birth at home.

A recent retrospective study found that the risk of a newborn having a seizure or having lower than a 7 on the 5-minute Apgar score was much higher for babies whose mothers had intended home births. Meanwhile, birthing centers had the lowest rates of an Apgar score under 7.

"Hospitals and birthing centers are the safest places to give birth."

Lead author Dr. Yvonne Cheng, PhD, from the Obstetrics & Gynecology department at the University of California, San Francisco, is presenting findings that compare births occurring at birthing centers, at hospitals, and at home by choice in the wake of a report from the Centers of Disease Control about increases in home births.

The CDC reported at the end of January that home births increased by 29 percent from 2004 to 2009. They are most common among non-Hispanic white women over age 35 who already have children.

Cheng's team look at U.S. births in 2008 that included information on the birth facility type, excluding stillbirths and births of multiples.

Of the 2,296,953 births they investigated, about a half percent delivered at birthing centers and a half percent had intended home births.

Women birthing away from hospitals had only a 0.02 to 0.04 percent likelihood of having a C section compared to a 24 percent chance if they had their babies at a hospital.

However, an Apgar score under 7 was more than twice as likely for babies born at home intentionally compared to babies born at a hospital. Neonatal seizures among home births occurred almost three times more often than at hospitals.

The Apgar score is a score from 1-10 to quickly measure the health of an infant right after birth

"This trade-off between maternal benefit and neonatal risk of deliveries outside of hospitals should be weighed in the decision regarding birthing facility preferences," Cheng and her colleagues concluded.

Babies born in birthing centers had an 18 percent lower incidence of Apgar scores under 7 compared to hospitals.

The risk of a baby having a seizure was not significantly different between hospitals and birthing centers.

The study was presented February 10 at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, in Dallas, TX. No information was available regarding the study's funding or financial disclosures of the authors.

Reviewed by: 
Review Date: 
February 10, 2012
Last Updated:
February 12, 2012