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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