Letters

Home births

BMJ 1997; 314 doi: http://dx.doi.org/10.1136/bmj.314.7081.678 (Published 01 March 1997) Cite this as: BMJ 1997;314:678

Difficulties arise when women choose not to take advantage of professional help

  1. Susan C Thomas, Midwife informatics codirector, Cardiff births surveya,
  2. Jacqueline A Bethel, Clinical databases managerb
  1. a c/o Directorate of Women's and Children's Health, Llandough Hospital, Penarth CF64 2XX
  2. b Department Medical Computing and Statistics, University of Wales College of Medicine, Cardiff CF4 4XN
  3. c St Stephen's Health Centre, London E3 5ED
  4. d Department of General Practice and Primary Care, St Bartholomew's and the Royal London School of Medicine and Dentistry, London EC1M 6BQ
  5. e The Mill House, Wantage OX12 9EH
  6. f West Midlands Perinatal Audit, Solihull Hospital, Solihull B91 2JH
  7. g Maternity Survey Office, Newcastle upon Tyne NE2 4AA

    Editor–The Northern Region Perinatal Mortality Survey Coordinating Group, reporting perinatal loss in planned and unplanned home births, found a much greater hazard associated with unplanned delivery outside hospital.1 We wish to report a similar analysis of data from the Cardiff births survey for the years 1991-5.2

    During this period there were 28 626 deliveries to residents of South Glamorgan. We excluded 992 that were planned deliveries outside the area and 85 in which the actual delivery was outside the area, leaving 27 549 deliveries. We excluded 32 deaths due to congenital abnormalities and 1985 deliveries in which the birth weight was less than 2500 g, leaving 25 532 deliveries. In 83 deliveries the birth weight was unknown, which left 25 449 deliveries for analysis.

    One hundred and thirty seven women planned to deliver at home. No perinatal or neonatal deaths occurred in the 94 who did deliver at home. In the 43 transfers to hospital for delivery one stillbirth occurred. There were six deliveries at home to women who had made no arrangements for professional care during pregnancy or labour, representing 2% (6/346) of all home deliveries. In this group two stillbirths occurred; both the babies were apparently full term but the deliveries were unattended.

    These data support the view that planned home delivery can be just as safe as hospital care. The difficulties arise when women, for whatever reason, choose not to take advantage of professional help. It is thus difficult to see how health authorities purchasing maternity care can provide for these women as recommended by the Northern Region Perinatal Mortality Survey Coordinating Group.

    References

    1. 1.
    2. 2.

    More evidence is required on most effective means of providing newborn examination

    1. Pat Hoddinott, General practitionerc,
    2. Martin Underwood, Senior lecturerd
    1. a c/o Directorate of Women's and Children's Health, Llandough Hospital, Penarth CF64 2XX
    2. b Department Medical Computing and Statistics, University of Wales College of Medicine, Cardiff CF4 4XN
    3. c St Stephen's Health Centre, London E3 5ED
    4. d Department of General Practice and Primary Care, St Bartholomew's and the Royal London School of Medicine and Dentistry, London EC1M 6BQ
    5. e The Mill House, Wantage OX12 9EH
    6. f West Midlands Perinatal Audit, Solihull Hospital, Solihull B91 2JH
    7. g Maternity Survey Office, Newcastle upon Tyne NE2 4AA

      Editor–The Northern Region Perinatal Mortality Survey Coordinating Group and J Davies and colleagues report low perinatal mortality in planned home births but a reluctance among general practitioners to support such births.1 …

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