title: Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis.
abstract: OBJECTIVE
  We sought to systematically review the medical literature on the maternal and newborn safety of planned home vs planned hospital birth.
  
  
  METHODS
  We included English-language peer-reviewed publications from developed Western nations reporting maternal and newborn outcomes by planned delivery location. Outcomes' summary odds ratios with 95% confidence intervals were calculated.
  
  
  RESULTS
  Planned home births were associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation. Although planned home and hospital births exhibited similar perinatal mortality rates, planned home births were associated with significantly elevated neonatal mortality rates.
  
  
  CONCLUSIONS
  Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME, USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Wax
authors.forename: F Lee
authors.initials: FL
authors.lastname: Lucas
authors.forename: Maryanne
authors.initials: M
authors.lastname: Lamont
authors.forename: Michael G
authors.initials: MG
authors.lastname: Pinette
authors.forename: Angelina
authors.initials: A
authors.lastname: Cartin
authors.forename: Jacquelyn
authors.initials: J
authors.lastname: Blackstone
mesh_terms: D015360:Analgesia, Epidural / Q000706:statistics & numerical data; D016362:Analgesia, Obstetrical / Q000706:statistics & numerical data; D001724:Birth Weight; D015148:Cardiotocography / Q000706:statistics & numerical data; D036861:Delivery, Obstetric; D004841:Episiotomy / Q000706:statistics & numerical data; D005260:Female; D006700:Home Childbirth; D006760:Hospitalization; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D054238:Perinatal Mortality; D010502:Perineum / Q000293:injuries; D018457:Placenta, Retained / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D011273:Pregnancy, Prolonged / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D014592:Uterine Hemorrhage / Q000453:epidemiology