Perinatal outcome in hospital and birth center obstetric care.
OBJECTIVE
Our purpose was to compare birth complications and fetal outcome in hospitals and birth centers.


METHODS
We retrospectively compared all 801 deliveries between 1992 and 1994 from two free-standing birth centers against 3271 hospital deliveries in Berlin. The hospital collective was selected according to the same risk criteria of the birth centers.


RESULTS
The birth center group had significantly fewer medical interventions, with a similar cesarean section rate (3.0% vs. 4.6%, P = 0.057) and occurrence of severe perineal lesions. The episiotomy rate was significantly higher (P < 0.001) in the clinics for first-time and multiple births. The perinatal mortality was not significantly different ( < 0.1 per 1000). One-minute Apgar scores less than 7 were found significantly more often in the birth center group.


CONCLUSIONS
When birth centers employ thorough risk selection and significant early referral rates to nearby hospitals, there is no evidence of increased maternal or perinatal risk compared to hospital deliveries.
Department of Obstetrics and Gynecology, Humboldt University School of Medicine, Berlin, Germany. matthias.david@charite.de
M
M
David
H K
HK
von Schwarzenfeld
J A
JA
Dimer
H
H
Kentenich
D016550:Birthing Centers / Q000706:statistics & numerical data; D003696:Delivery Rooms / Q000706:statistics & numerical data; D005260:Female; D005313:Fetal Death; D005858:Germany; D006801:Humans; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000592:standards*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011787:Quality of Health Care; D012189:Retrospective Studies