America's
Birthing Statistics
| |
WHO
Recommendations |
CIMS
Suggestions |
United
States
Statistics, 2000 |
| Birth
Attendants |
| Place
of Birth |
| Electronic
Fetal Monitoring |
| Drugs
in Labor |
| Induction
of Labor |
| Stimulation
of Labor |
| Episiotomies |
| Cesarean
Rate |
| Breastfeeding
After Birth |
|
|
Midwives
for normal
pregnancy and birth |
Access
to professional midwifery care |
Physicians
91.7% |
|
Out-Of-Hospital
preferred |
Where
mother prefers |
Hospitals
99.1% |
| Not
routine |
Not
routine |
83.5% |
|
Not
routine |
Only
for complications |
80-98% |
|
10%
or less |
10%
or less |
19.7% |
|
Not
mentioned |
10%
or less |
17.8% |
|
Systematic
use not justified |
Goal
of 5% |
34% |
|
10-15% |
10-15% |
22.9% |
|
Immediately |
Follow
WHO guidelines |
67% |
|
|
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"So far,
the largest and most complete study on the comparison of hospital birth
outcomes to that of homebirth outcomes was done by Dr. Lewis Mehl and
associates in 1976. In the study, 1046 homebirths were compared with
1046 hospital births of equivalent populations in the United States.
For each home-birth patient, a hospital-birth patient was matched for
age, length of gestation, parity (number of pregnancies), risk factor
score, education and socioeconomic status, race, presentation of the
baby and individual major risk factors. The homebirth population also
had trained attendants and prenatal care.
"The results of this
study showed a three times greater likelihood of cesarean operation
if a woman gave birth in a hospital instead of at home with the hospital
standing by. The hospital population revealed twenty times more use
of forceps, twice as much use of oxytocin to accelerate or induce labor,
greater incidence of episiotomy (while at the same time having more
severe tears in need of major repair). The hospital group showed six
times more infant distress in labor, five times more cases of maternal
high blood pressure, and three times greater incidence of postpartum
hemorrhage. There was four times more infection among the newborn; three
times more babies that needed help to begin breathing. While the hospital
group had thirty cases of birth injuries, including skull fractures,
facial nerve palsies, brachial nerve injuries and severe cephalohematomas,
there were no such injuries at home.
"The infant death rate
of the study was low in both cases and essentially the same. There were
no maternal deaths for either home or hospital. The main differences
were in the significant improvement of the mother's and baby's health
if the couple planned a homebirth, and this was true despite the fact
that the homebirth statistics of the study included those who began
labor at home but ultimately needed to be transferred to the hospital."
Dr. Lewis Mehl, "Home
Birth Versus Hospital Birth: Comparisons of Outcomes of Matched Populations."
Presented on October 20, 1976 before the 104th annual meeting of the
American Public Health Association. For further information contact
the Institute for Childbirth and Family Research, 2522 Dana St., Suite
201, Berkeley, CA 94704
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