Home births are on the rise. But they come with some risks.

By Carolyn Y. Johnson

Expectant mothers in the U.S. remain at a high risk for pregnancy-related death. (iStock)

A hospital birth is slightly safer for the baby than one outside the hospital, but the risks are low. (iStock)

Choosing to have a baby outside a hospital comes with a slight increased risk of death to the baby in the United States but a lower likelihood of a C-section, according to a study of Oregon births published this week in the New England Journal of Medicine.

But the overall risks to the baby remained small regardless of the birth plan — there were about two deaths per 1,000 births among planned hospital births, vs. four deaths per 1,000 births planned at home or in birthing centers.

“Absolute risk of death is low in all settings — less than half of a percent. … And in terms of that added risk, we see how someone weighs that as a personal choice,” said Jonathan Snowden, an epidemiologist at Oregon Health and Science University who led the study, which examined nearly 80,000 low-risk births in Oregon during 2012 and 2013.

Women who planned to give birth outside of the hospital experienced very different kinds of birth. Far fewer women had their labor induced. A quarter of women who planned hospital births had C-sections that can add serious complications to future pregnancies — five times the rate of C-section among those who planned to give birth outside the hospital. For planned out-of-hospital births, there was an increase in some complications, such as seizures and low Apgar scores (a measure of a newborn’s overall health), but the absolute risk remained low.

Giving birth at home is still a rarity — less than 1 percent of women in the United States gave birth at home in 2012. But home births have been on the rise, and it has been hard to assess …read more

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