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Research paper
Published online: 2023-01-13
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Complications of planned home births in the Czech Republic

Petr Krepelka12, Hynek Herman12, Petr Velebil12, Alena Mechurova12, Jiri Hanacek12, Zbynek Stranak12, Jaroslav Feyereisl12
DOI: 10.5603/GP.a2023.001
Affiliations
  1. The Institute for the Care of Mother and Child, Prague, Podoli, Czech Republic
  2. 3rd Faculty of Medicine, Charles University, Prague, Czech Republic

open access

Ahead of Print
ORIGINAL PAPERS Obstetrics
Published online: 2023-01-13

Abstract

Objectives: This study evaluated complications that can occur during planned home births that require transfer to the hospital. These factors were assessed to improve the current status of deliveries performed outside health care facilities in the Czech Republic.

Materials and methods: This prospective cohort study included data on 105 cases of complicated home births during 2017 to 2021 using an online form accessible to all hospital maternity wards in the Czech Republic.

Results: Planned home births were complicated by fetal/neonatal causes, maternal causes, and combined fetomaternal complications in 28 (26.7%), 20 (19%), and 2 (1.9%) cases, respectively. The need for transfer was most often realized after the birth of the fetus (86; 81.9%); however, it was realized during birth in 19 (18.1%) cases. The following complications were noted most often: postpartum hemorrhage (23; 21.9%); neonatal asphyxia (17; 16.2); placental retention (14; 13.3%); birth injury (12; 11.4%); neonatal hypothermia (5; 4.8%); and placental birth (5; 4.8%). Indications for transfer during labor were as follows: labor obstruction (10; 9.5%); fetal hypoxia (5; 4.8%); bleeding during labor (2; 1.9%); preeclampsia (1; 0.9%); and fetal malformation (1; 0.9%). Perinatal death occurred in 8 (7.6%) cases. Permanent neonatal morbidity occurred in 4 (3.8%) cases.

Conclusions: Patients with home birth complications were transferred to the hospital most often after the birth of the fetus. The low proportion of transfers during childbirth is caused by the unprofessional management of planned home births, resulting in a high number of perinatal deaths and high rate of permanent neonatal morbidity.

Abstract

Objectives: This study evaluated complications that can occur during planned home births that require transfer to the hospital. These factors were assessed to improve the current status of deliveries performed outside health care facilities in the Czech Republic.

Materials and methods: This prospective cohort study included data on 105 cases of complicated home births during 2017 to 2021 using an online form accessible to all hospital maternity wards in the Czech Republic.

Results: Planned home births were complicated by fetal/neonatal causes, maternal causes, and combined fetomaternal complications in 28 (26.7%), 20 (19%), and 2 (1.9%) cases, respectively. The need for transfer was most often realized after the birth of the fetus (86; 81.9%); however, it was realized during birth in 19 (18.1%) cases. The following complications were noted most often: postpartum hemorrhage (23; 21.9%); neonatal asphyxia (17; 16.2); placental retention (14; 13.3%); birth injury (12; 11.4%); neonatal hypothermia (5; 4.8%); and placental birth (5; 4.8%). Indications for transfer during labor were as follows: labor obstruction (10; 9.5%); fetal hypoxia (5; 4.8%); bleeding during labor (2; 1.9%); preeclampsia (1; 0.9%); and fetal malformation (1; 0.9%). Perinatal death occurred in 8 (7.6%) cases. Permanent neonatal morbidity occurred in 4 (3.8%) cases.

Conclusions: Patients with home birth complications were transferred to the hospital most often after the birth of the fetus. The low proportion of transfers during childbirth is caused by the unprofessional management of planned home births, resulting in a high number of perinatal deaths and high rate of permanent neonatal morbidity.

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Keywords

home birth; complication; neonatal death; neonatal morbidity; maternal morbidity

About this article
Title

Complications of planned home births in the Czech Republic

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2023-01-13

Page views

30

Article views/downloads

15

DOI

10.5603/GP.a2023.001

Keywords

home birth
complication
neonatal death
neonatal morbidity
maternal morbidity

Authors

Petr Krepelka
Hynek Herman
Petr Velebil
Alena Mechurova
Jiri Hanacek
Zbynek Stranak
Jaroslav Feyereisl

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