Original researchOutcomes of planned home births in Washington State: 1989–19961
Section snippets
Materials and methods
We conducted a population-based cohort study using Washington State birth certificate data from 1989 to 1996. The birth certificate data were linked to the Washington State infant death certificates to identify cases of neonatal death and postneonatal death. Other outcomes such as postpartum bleeding, prolonged labor, neonatal respiratory distress (defined as postdelivery ventilation for more than 30 minutes), and a very low Apgar score (≤3) at 5 minutes were identified through information
Results
Relative to women intending to deliver in hospital, those intending to deliver at home were, on average, older, more likely to be married, white, nonsmokers, and parous (Table 1). They also tended to be more highly educated; however, data on education were not collected for mothers giving birth before 1992 (almost 50% of both of the home birth and hospital birth cohorts). Women intending to deliver at home were slightly less likely to reside in an urban area, to live in King County, to have
Discussion
Although mothers intending to deliver infants at home were more likely to be at least 20 years old, married, nonsmokers, and insured than mothers who delivered in hospitals, planned home births were associated with an elevated risk of neonatal mortality and very low Apgar score at 5 minutes in this study. Planned home births were also associated with increased risk of prolonged labor and postpartum bleeding among nulliparous women. The incidence of neonatal mortality was 3.5 out of 1000 live
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Cited by (0)
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We thank the Washington State Department of Health for providing access to birth certificate data, Paul Doria-Rose and Susan Nielson-Searles for their editorial assistance, and William O’Brien from the University of Washington for his computer programming assistance.