Notre travail

Further Neonatal Mortality and Prematurity Follow-up

We have produced a more detailed assessment of neonatal risks in the CPM200 Study than was possible in the BMJ article:

Neonatal Mortality Risks Similar in Careful Comparison of the CPM2000 and the 2004 U.S. Neonatal Mortality among Term Births to non-Hispanic White Women, but Prematurity Lower with Midwives

A FOLLOW-UP ON: Johnson, K.C., Daviss, B.A., 2005. Outcomes of planned home births with certified professional midwives: large prospective study in North America. British Medical Journal 330, 1416. June 18th, 2005

Kenneth C. Johnson, PhD and Betty-Anne Daviss, MA, RM

SUMMARY

We compare the CPM2000 neonatal mortality rate among planned homebirths to the U.S. National Institutes of Health (NIH) neonatal mortality rate for births in hospital to U.S. non-Hispanic white women of 37 weeks plus gestation in the year 2004. Adjustments are made to ensure that the comparison is as close as possible to comparing like with like. This includes removal from the CPM2000 death rate of intrapartum mortality, 3 deaths involving lethal birth defects unlikely to have been carried to term in the hospital population, and 1 death and 286 births among African-American and Hispanic women. After making the necessary adjustments that were possible, the neonatal death rate in both datasets was just under 1 death per 1000. Our conclusions remains unchanged from those in the original article—the neonatal mortality rate for low risk women in North America using certified professional midwives is similar to that for low risk women in hospital in the U.S., and the intervention rates are much lower. We note that the premature birth rate for the NIH non- Hispanic white births in hospital was 11.3%, more than double the rate for the women cared for by Certified Professional Midwives (CPMs). Higher prematurity is a serious concern for the U.S. hospital births, because prematurity is associated with much higher perinatal mortality and morbidity.

Download the full article here.

Important Recent Home Birth Studies

The studies below are important compliments to our study.

Schlenzka, Peter F., Safety of Alternative Approaches to Childbirth. Standford University Department of Sociology. 1999; 1-436
http://www.vbfree.org/docs/safety.rtf

de Jonge A., van der Goes BY, Ravelli AC, melink-Verburg MP, Mol BW, Nijhuis JG et al. Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births. BJOG 2009; 116(9):1177-1184.
http://www3.interscience.wiley.com/journal/122323202/abstract

Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ 2011;343:d7400.
http://www.bmj.com/content/343/bmj.d7400

Hutton EK, Reitsma AH, Kaufman K. Outcomes associated with planned home and planned hospital births in low-risk women attended by midwives in Ontario, Canada, 2003-2006: a retrospective cohort study. Birth 2009; 36(3):180-189.
http://www3.interscience.wiley.com/journal/122592329/abstract?CRETRY=1&SRETRY=0

Johnson, Kenneth C., Daviss, Betty-Anne. Outcomes of planned home births with certified professional midwives: large prospective study in North America. British Medical Journal. 2005; 330.
http://understandingbirthbetter.com/files/uploads/BMJCPM2000QuestionsAndAnswersMay2008v2.pdf

Janssen PA, Saxell L, Page LA, Klein MC, Liston RM, Lee SK. Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. CMAJ 2009; 181(6-7):377-383.
http://www.cmaj.ca/cgi/pmidlookup?view=long&pmid=19720688