Category Archives: Delivery

Study Finds Increasing Trend in Home Birth Neonatal Mortality Rates

In a study to be presented on Feb. 7 at 2:15 p.m. CST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in New Orleans, researchers will report that patients delivered at home by midwives had a roughly four times higher risk of neonatal deaths than babies delivered in the hospital by midwives. The increased neonatal mortality risk is associated with the location of a planned birth, rather than the credentials of the person delivering the baby.

The number of homebirths in the United States has grown over the last decade. In the largest study of its kind, using Centers for Disease Control data on nearly 14 million linked infant birth and neonatal death data, term singleton U.S. births, researchers at New York-Presbyterian/Weill Cornell Medical Center found the absolute risk of neonatal mortality was 3.2/10,000 births in midwife hospital births, and 12.6/10,000 births in midwife home births, and it further increased in first-time mothers to 21.9/10,000 births in midwife home deliveries. Neonatal mortality was defined as neonatal deaths up to 28 days after delivery.

“This risk further increased to about seven-fold if this was the mother’s first pregnancy, and to about ten-fold in pregnancies beyond 41 weeks,” said Amos Grunebaum, M.D.

The excess total neonatal mortality for deliveries performed by home midwives was 9.3/10,000 births or about 18-19 excess neonatal deaths a year from midwife homebirths. Based on the most recent 2012 births data, the authors concluded that if home births by midwives continue to grow at the present 10 percent yearly rate, then the excess total neonatal mortality of home births by midwives would nearly double  from about 16-17 in 2009 to about 32 in 2016.

Given the study’s findings, Amos Grunebaum, M.D. and Frank Chervenak, M.D., the main authors of the study, said that obstetric practitioners have an ethical obligation to disclose the increased absolute and relative risks associated with planned home birth to expectant parents who express an interest in this delivery setting, and to recommend strongly against it.

The authors also continued to say that hospitals should create a welcoming and comfortable birthing environment, as well as address unnecessary obstetric interventions, both of which are often a primary motivation for planned homebirth.

Study co-authors include Laurence B. McCullough, Ph.D., at Baylor College of Medicine and Weill Cornell Medical College, Katherine J. Sapra, MPH, at Columbia University, Robert L. Brent M.D., Ph.D., at Thomas Jefferson University and Weill Cornell Medical College, Malcolm I. Levene, M.D., FRCP, FRCPCH at the University of Leeds, and Birgit Arabin, M.D., at Philipps University and Clara Angela Foundation.

# # #

A copy of the abstract is available at http://www.smfmnewsroom.org and below.  For interviews please contact Vicki Bendure at Vicki@bendurepr.com 202-374-9259 (cell), or Meghan Blackburn at Meghan@bendurepr.com, 540-687-5099 (office) or 859-492-6303 (cell).

The Society for Maternal-Fetal Medicine (est. 1977) is the premiere membership organization for obstetricians/gynecologists who have additional formal education and training in maternal-fetal medicine.  The society is devoted to reducing high-risk pregnancy complications by sharing expertise through continuing education to its 2,000 members on the latest pregnancy assessment and treatment methods. It also serves as an advocate for improving public policy, and expanding research funding and opportunities for maternal-fetal medicine. The group hosts an annual meeting in which groundbreaking new ideas and research in the area of maternal-fetal medicine are shared and discussed.  For more information visit www.smfm.org.

 

Abstract 57: Term neonatal deaths resulting from home births: An increasing trend

Authors: Amos Grunebaum1, Kate Sapra2, Frank Chervenak1

1New York Weill Cornell Medical College, New York, NY, 2Columbia University, New York, NY

Objective: Home births have increased over the last years. The objective of our study was to examine excess term neonatal mortality rates by birth location (hospital, birthing centers, and home births) and by providers (midwives, doctors, and “others” for home births) and to document the number of excess neonatal deaths resulting from the increase in home births.

Study Design: A retrospective cohort study using the CDC linked birth/infant death data set for term (>=37 weeks), >=2500 grams, singleton live births, excluding congenital anomalies from 2007 to 2009. Deliveries were categorized by setting: hospitals, birthing centers, and home as well as providers (midwives, doctors, and “others” for home births). Neonatal mortality (NNM) was defined as neonatal deaths up to 28 days after delivery. Hospital midwives served as reference.

Results: There were a total of 10,453,778 term deliveries between 2007 and 2009 which met study criteria: 9,526,450 (91.13%) were by hospital physicians, 826,543 (7.91%) by hospital midwives, 30,415 (0.29%) by midwives in freestanding birthing centers, 48,202 (0.46%) by midwives at home, and 22,168 (0.21%) by others at home. NNM for those delivered at home by others and by midwives, and those delivered in a freestanding birthing center was significantly higher than those delivered by midwives in the hospital: hospital midwives: 3.1/10,000 (RR:1); home others: 18.2/10,000 (RR: 5.87; 95%CI: 4.21-8.19), home midwives: 13.2/10,000; (RR: 4.32 95%CI: 3.29-5.68), freestanding birthing center: 6.3/10,000;(RR: 2.03; 95%CI: 1.28-3.24). The excess NNM for home births by midwives was 10.2/10,000 births (95% CI 6.9-13.2), and 15.0/10,000 births (95% CI 9.4-20.6) for home births by “others”.

Conclusion: Our study documents the number of excess term neonatal deaths resulting from home births. If home births continue to grow at a 6% per year rate, then excess yearly neonatal deaths from home births will increase by about 1/3 from about 31 in 2010 to about 42 in 2015.

 

Predicted Excess Neonatal Deaths From Home Births By Year

Predicted Excess Neonatal Deaths From Home Births By Year

Total and Excess Neonatal Mortality By Setting and Attendant

Total and Excess Neonatal Mortality By Setting and Attendant

 

 

Study Suggests Around-the-Clock Labor Coverage is Associated with a Higher Likelihood of Trial of Labor for Women who Previously had Cesarean Delivery

In a study to be presented on February 16 between 8 a.m., and 10 a.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in San Francisco, researchers will report findings that suggest around-the-clock labor and delivery coverage decreased the odds of cesarean delivery.

Study Finds That Planned C-Sections Provide No Advantage Over Planned Vaginal Birth of Twins

In a study to be presented on February 14 between 8 a.m., and 10 a.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in San Francisco, researchers will report findings that suggest that planned birthing of twins at 32-38 weeks by cesarean section does not decrease perinatal or neonatal death compared to planned vaginal birth.

MOD Award Abstract: Study Shows Progesterone Shots Do Not Reduce Preterm Delivery in Twin Pregnancies

In a study to be presented on February 14 between 8 a.m. and 10 a.m. PST, at the Society for Maternal-Fetal Medicine’s 33rd annual meeting, The Pregnancy Meeting ™, researchers will report findings that suggest that 17P, a form of progesterone, is not effective in preventing preterm birth among women with twin pregnancies — and may possibly be harmful.

Differences in Obstetric Outcomes and Care Related to Race and Ethnicity

In a study to be presented on February 14 between 1:15 p.m., and 3:30 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in San Francisco, California, researchers will present data showing racial and ethnic disparities exist for adverse obstetric outcomes.

Study Shows New Model of “Laborist” Obstetrical Care Improves Pregnancy Outcomes

In a study to be presented on February 16 between 8 a.m., and 10 a.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in San Francisco, researchers will report findings that suggest shifting from a traditional model of obstetrical care to a laborist model improves pregnancy outcomes.

Policy Changes in Elective Delivery Proven Successful

In a study to be presented on February 14 between 1:15 p.m., and 3:30 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in San Francisco, California, researchers will present data showing changes in elective delivery policy have been successful in reducing elective deliveries prior to 39 weeks.

Society for Maternal Fetal Medicine Recognizes Medical Advancements on World Prematurity Day

Improved screening and effective treatments for prevention of preterm birth are saving infants

In the last five years, multiple medical advancements have led to a decline in the nation’s premature birthrate. On Nov. 17, the Society for Maternal-Fetal Medicine (SMFM) will celebrate World Prematurity Awareness Day to raise global awareness of the problems with premature birth

Study Weighs Risks and Benefits of Birthing Facilities

Full abstract at the bottom of the page. Click Here to view all 2012 abstracts.

Study Weighs Risks and Benefits of Birthing Facilities

In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that indicate that the risk of obstetric intervention is lower for women who deliver or intend to deliver outside of hospitals, but there are some higher risks for newborns intended for home births compared to hospital births.

Study Finds Preterm Labor Diagnostic Markers Not Universal, Diagnosis and Interventions Should Not Be Generalized

Full abstract at the bottom of the page. Click Here to view all 2012 abstracts.

Study Finds Preterm Labor Diagnostic Markers Not Universal, Diagnosis and Interventions Should Not Be Generalized

In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that indicate that preterm birth interventions should be tailored for underlying risk factors and pathways.

Study Finds in Women with Prior Cesarean, Optimal Gestational Age for Elective Delivery is Week 39

Full abstract at the bottom of the page. Click Here to view all 2012 abstracts.

Study Finds in Women with Prior Cesarean, Optimal Gestational Age for Elective Delivery is Week 39

In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that indicate that for women with prior delivery via cesarean section the optimal timing of elective delivery for mother and baby is 39 weeks even after consideration of the risk with continuing pregnancy.

Study Finds Pregnant Women with Prior Cesarean Choose the Delivery Method Preferred by Their Doctor

Full abstract at the bottom of the page. Click Here to view all 2012 abstracts.

Study Finds Pregnant Women with Prior Cesarean Choose the Delivery Method Preferred by Their Doctor

 In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that women who have undergone one prior delivery via cesarean section appear to know little about the risks and benefits associated with undergoing either a second cesarean or trial of labor to attempt a vaginal delivery, and that the preference of their medical provider strongly affects their selection between the two options.

Study Finds Residence in U.S. a Risk Factor for Preterm Birth

Full abstract at the bottom of the page. Click Here to view all 2012 abstracts.

Study Finds Residence in U.S. a Risk Factor for Preterm Birth

 In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that indicate that duration of stay in the United States is associated with increased risk of preterm birth for Hispanic women.

Study Finds Some Medications May Interact with Common Anti- Recurrent Preterm Birth Medication

Full abstract at the bottom of the page. Click Here to view all 2012 abstracts.

Study Finds Some Medications May Interact with Common Anti- Recurrent Preterm Birth Medication

In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that indicate that prescription medications may affect the body’s ability to metabolize 17-alpha-hydroxyprogesterone caproate (17-OHPC), the only FDA approved medication for the prevention of recurrent preterm birth.

Study Indicates That Cesarean Delivery May Not Be More Protective for Small, Premature Newborns

Full abstract at the bottom of the page. Click Here to view all 2012 abstracts.

Study Indicates That Cesarean Delivery May Not Be More Protective for Small, Premature Newborns 

In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that suggest that delivery by cesarean section may not be protective compared to vaginal deliveries for babies who are small for their gestational age (those weighing less than the 10th percentile at birth based on national growth curves) born more than six weeks before their due date.

Study Finds Prior Preterm Delivery Indicates Subsequent Baby Will Be Small Even if Carried to Term

Full abstract at the bottom of the page. Click Here to view all 2012 abstracts.

Study Finds Prior Preterm Delivery Indicates Subsequent Baby Will Be Small Even if Carried to Term

In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that indicate that women who deliver their first baby early are more likely to have a subsequent baby that is small for its gestational age, even when the second pregnancy is carried to term.

WHITE PAPER: Quality Patient Care in Labor and Delivery: A call to Action

Introduction

Pregnancy and birth are physiologic processes, unique for each woman, that usually proceed normally. Most women have normal conception, fetal growth, labor, and birth and require minimal or no intervention in the process. Women and their families hold different views about childbearing based on their knowledge, experiences, belief systems, culture, and social and family backgrounds.

As representatives of professional societies whose members care for pregnant and laboring women, we agree that patient-centered and safe care of the mother and child enhance quality and is our primary priority. Optimal maternal health outcomes can best be achieved in an atmosphere of effective communication, shared decision-making, teamwork, and data-driven quality improvement initiatives.

“Patient-centered” means that health care providers, and the system in which they practice, accept that the values, culture, choices, and preferences of a woman and her family are relevant within the context of promoting optimal health outcomes. The overarching principles involved include treating all childbearing women with kindness, respect, dignity, and cultural sensitivity, throughout their maternity care experiences. Patient-centered care is enhanced when women are provided supportive resources such as education and skilled attendants. Specifically, patient-centered care requires a balance between maternal-child safety and well-being and the woman’s needs and desires.

2011: Leading Health Care Organizations Issue Recommendations for Quality Patient Care in Labor and Delivery

Unprecedented Collaboration Creates Joint Call to Action 

The nation’s leading health care organizations in the areas of obstetrics-gynecology, family medicine, and pediatrics issued an unprecedented call to action today for the nation’s health care providers and administrators.

The collaboration, which includes the American Academy of Family Physicians; the American Academy of Pediatrics; the American College of Nurse-Midwives; the American College of Obstetricians and Gynecologists; the American College of Osteopathic Obstetricians & Gynecologists; the Association of Women’s Health, Obstetric and Neonatal Nurses; and the Society for Maternal-Fetal Medicine, was brought about by the need to develop an interdisciplinary collaborative approach to patient care to optimize maternal and fetal health outcomes.

2011: Study finds that women used 30 percent less analgesia during labor when they administered it themselves

In a study to be presented today at the Society for Maternal-Fetal Medicine’s (SMFM) annual meeting, The Pregnancy Meeting ™, in San Francisco, researchers will present findings that show that when women administer their own patient-controlled epidural analgesia (PCEA) instead of getting a continuous epidural infusion (CEI) they used less analgesic, but reported similar levels of satisfaction.

Study finds that when first time mother are induced, breaking the amniotic membrane shortens delivery time significantly

In a study to be presented today at the Society for Maternal-Fetal Medicine’s (SMFM) annual meeting, The Pregnancy Meeting ™, in San Francisco, researchers will present findings that show that by performing an amniotomy on first time mothers in situations when labor has to be induced, that delivery time can be shortened by more than 10 percent.

Powered by WordPress | Designed by: seo service | Thanks to seo company, web designers and internet marketing company