Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis

Objective

We sought to systematically review the medical literature on the maternal and newborn safety of planned home vs planned hospital birth.

Study Design

We included English-language peer-reviewed publications from developed Western nations reporting maternal and newborn outcomes by planned delivery location. Outcomes' summary odds ratios with 95% confidence intervals were calculated.

Results

Planned home births were associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation. Although planned home and hospital births exhibited similar perinatal mortality rates, planned home births were associated with significantly elevated neonatal mortality rates.

Conclusion

Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate.

Key words: neonatal mortality, patient safety, planned home childbirth