A new study by researchers at Ben-Gurion University of the Negev (BGU) shows that women who give birth in non-hospital settings in Israel are three times more likely to encounter complications, leading to perinatal mortality, than their counterparts who have their babies in hospitals.
The researchers define perinatal mortality as the death of a newborn at delivery or within the first six weeks of life.
The findings of the study, conducted by Prof. Eyal Sheiner and Dr. Tamar Weinstock, both of BGU’s Faculty of Health Science, and Dr. Gil Gutvirtz of the Department of Obstetrics and Gynecology at Soroka University Medical Center in Beersheba, were presented last month at the Society for Maternal-Fetal Medicine’s 39th Annual Pregnancy Meeting in Las Vegas.
The researchers studied the births of 3,580 women who delivered babies in non-hospital settings and compared them to those of some 240,000 women who gave birth at Soroka University Medical Center between 1991 and 2014.
The group found that 15 out of every 1,000 babies born in non-hospital settings, including planned home births but also unplanned and accidental out-of-hospital births, died either at birth or in the six weeks post-partum, compared to just five out of every 1,000 babies born in hospitals.
When accounting for variables including the mother’s health, age, health habits (for example, whether she was a smoker) and ethnic background, the occurrence of a baby death remained 2.6 times higher compared with patients who delivered their babies in the hospital.
“This study matches the findings of larger studies conducted in the United States and confirmed our hypothesis that childbirth in non-hospital settings is far more dangerous than in hospitals,” said Sheiner, who serves as chairman of the obstetrics and gynecology department at Soroka and vice-dean at BGU’s Faculty of Health Sciences, in a statement.
“There is no question that a hospital provides the most secure environment to give birth, both for mothers and their babies,” he said. “Even with the advances of modern medicine, childbirth is still traumatic for both the mother and child and it is critical to prepared for any scenario.
“Perhaps once-upon-a-time the difference between home and hospital for giving birth was less important because of our ancestors’ limited understanding of medicine, but today there is a quantum difference,” Sheiner added.
“Tracking both the mothers’ and babies’ progress, heart rate, blood pressure and overall health in real time and immediate access to operating theaters and emergency treatment in the event of a problem gives the medical team the best chance to navigate the difficult situation effectively,” he said.
Globally, some 2.5 million children died in their first month of life in 2017, according to UNICEF data published in March 2018, most of them in the first week of life, with about a million babies dying on their first day and close to a million dying within the next six days.