German Out-of-Hospital Birth / Summaries

Summary 2010 / Summary 2011 / Summary 2012 / Summary 2013 / Summary 2014

Summary 2014

11,157 singleton births starting out-of-hospital (39.8% first-time mothers) were reported in 2013. Planned out-of-hospital births account for about 1.3% of all births in Germany.
Mothers-to-be and midwives carefully chose a suitable place of birth. The out-of-hospital birth settings varied: 3,862 home births and 7,295 births in midwife-led institutions like independent birth centres. Of all women, 95% had no specific problems. During birth, 16.7% of the women were transferred to a hospital. No woman died during or after birth.
The following data (presented according to intention to treat) show that midwives offered intensive care for mother and child on a low level of intervention.

 

Spontaneous birth

90.5%

Preferred birthing position

vertical

Intact perineum after vaginal birth

45.4%

Third or fourth degree perinael tear after vaginal birth

1.2%

Episiotomy

4.8%

C-section

6.8%

No intervention of any kind

36.0%

No problem after birth

95% of all mothers

Transfer after birth

3.6% of all mothers

5 minutes Apgar-score ≥ 7

99.3% of all live-births

Children's most frequent morbidity

breathing problems

Perinatal mortality

0.16% (= 1.6‰)

 

This data set supports the view that out-of-hospital midwifery care is safe for mother and child.

 


 

Summary 2013

10,600 singleton births starting out-of-hospital (41.8% first-time mothers) were reported in 2013. Out-of-hospital births account for about 1.5% of all births in Germany.
Mothers-to-be and midwives carefully chose a suitable place of birth. The out-of-hospital birth settings varied: 3,569 home births, 7,021 births in midwife-led institutions like independent birth centres, and 10 births in a centre run by an obstetrician. Of all women, 95% had no specific problems. During birth, 16.9% of the women were transferred to a hospital. No woman died during or after birth.
The following data (presented according to intention to treat) show that midwives offered intensive care for mother and child on a low level of intervention.

 

Spontaneous birth

90.7%

Preferred birthing position

vertical

Intact perineum after vaginal birth

45.4%

Third or fourth degree perinael tear after vaginal birth

1.1%

Episiotomy

4.6%

C-section

6.6%

No intervention of any kind

34.0%

No problem after birth

95% of all mothers

Transfer after birth

3.6% of all mothers

5 minutes Apgar-score ≥ 7

99.3% of all live-births

Children's most frequent morbidity

breathing problems

Perinatal mortality

0.15% (= 1.5‰)

 

This data set supports the view that out-of-hospital midwifery care is safe for mother and child.

 


 

Summary 2012

10,734 singleton births starting out-of-hospital (40.9% first-time mothers) were reported in 2012. Out-of-hospital births account for about 1.5% of all births in Germany.
Mothers-to-be and midwives carefully chose a suitable place of birth. The out-of-hospital birth settings varied: 3,689 home births, 7,024 births in midwife-led institutions like independent birth centres, and 21 births in a centre run by an obstetrician. Of all women, 96% had no specific problems. During birth, 16.8% of the women were transferred to a hospital. No woman died during or after birth.
the following data (presented according to intention to treat) show that midwives offered intensive care for mother and child on a low level of intervention.

 

Spontaneous birth

90.8%

Preferred birthing position

vertical

Intact perineum after vaginal birth

45.1%

Third or fourth degree perinael tear after vaginal birth

1.1%

Episiotomy

4.8%

C-section

6.4%

No intervention of any kind

33.4%

No problem after birth

96% of all mothers

Transfer after birth

3.3% of all mothers

5 minutes Apgar-score ≥ 7

99.3% of all live-births

Children's most frequent morbidity

breathing problems

Perinatal mortality

0.18% (= 1.8‰)

 

This data set supports the view that out-of-hospital midwifery care is safe for mother and child.

 


 

Summary 2011

10,377 singleton births starting out-of-hospital (40% first time mothers) were reported in 2011. Out-of-hospital births account for about 2% of all births in Germany.

Booking for the different out-of-hospital birth settings varied: 3,455 home births, 6,912 births started in midwife-led institutions like freestanding birth centres, and 10 births were reported in a centre run by an obstetrician. Mothers-to-be and midwives carefully chose the suitable place of birth. Of all pregnant women 91% had no particular problems. During birth 16.6% of all women were transferred to hospital. No woman died during or after birth.

Following data (calculated according to intention to treat) show that midwives offered intensive but not invasive care for mother and child.

 

Spontaneous birth

91%

Preferred birthing position

vertical

Intact perineum after vaginal birth

45%

Third or fourth degree perinael tear after vaginal birth

1.0%

Episiotomy

4.9%

C-section

6%

No intervention of any kind

31%

No problem after birth

94% of all mothers

Transfer after birth

3.5% of all mothers

5 minutes Apgar-score ≥ 7

99.3% of all live-births

Children's most frequent morbidity

breathing problems

Perinatal mortality

0.11% (= 1.1‰)

 

This data set supports the view that out-of-hospital midwifery care is safe for mother and child.

 


 

Summary 2010

10,699 singleton out-of-hospital births (38.4% first time mothers) were reported in 2010 (about 80% of all out-of-hospital births). Out-of-hospital births accounted for about 2% of all births in Germany.


The site of all 605 out-of-hospital birth settings varied: 3,709 home births; 6,982 births started in midwife-led institutions like freestanding birth centres; and 8 births were reported in a centre run by an obstetrician. Mothers-to-be and midwives carefully chose the suitable place of birth. Of all pregnant women 90.9% had no particular problems concerning this pregnancy. Women experiencing complications during birth were transferred to hospital. No woman died during or after birth.


Following data demonstrate that midwives offered intensive but not invasive care for mother and child.

 

Spontaneous birth of all births

91.4%

Preferred birthing position of all vaginal births

vertical

Intact perineum of all vaginal births

44.8%

Third or fourth degree perinael tear of all vaginal births

1.3%

Episiotomy of all vaginal births

5.1%

C-section of all births

6.0%

No intervention of any kind of all mothers

30.6%

No problem after birth of all mothers

94.3%

Transfer after birth of all mothers

3.8%

Transfer after birth of all children

2.7%

5 minutes Apgar-score > 7 of all live-births

99.3%

Breathing problems as the most frequent morbidity of all children

1.9%

Perinatal mortality

0.16% (= 1.6‰)

 

This data set supports the view that out-of-hospital midwifery care is safe for mother and child.


(Loytved, C. 2012 Qualitätsbericht 2010. Außerklinische Geburtshilfe in Deutschland. Im Auftrag der Gesellschaft für Qualität in der außerklinischen Geburtshilfe e.V. Verlag Wissenschaftliche Skripten, Zwickau)

 

 

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