German Out-of-Hospital Birth / Summaries

Extract from the statistics "Out-of-hospital births in Germany - quality report 2023"
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Extract from the statistics "Out-of-hospital births in Germany - quality report 2022"
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Extract from the statistics "Out-of-hospital births in Germany - quality report 2021"
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Extract from the statistics "Out-of-hospital births in Germany - quality report 2020"
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Extract from the statistics "Out-of-hospital births in Germany - quality report 2019"
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Extract from the statistics "Out-of-hospital births in Germany - quality report 2018"
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History

Summary 2010 / Summary 2011 / Summary 2012 / Summary 2013 / Summary 2014 / Summary 2015 / Summary 2016 / Summary 2017

Summary for out-of-hospital Births 2017

12,738 singleton births starting out-of-hospital (37.4% first-time mothers) were reported in 2017. 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: 5,494 home births and 7,244 births in midwife-led institutions like independent birth centres. Of all women, 16.6% were transferred during birth. 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

Spontaneous birth	91.7%
Preferred birthing position	On hands and knees
Intact perineum after vaginal birth	44.2%
Third or fourth degree perinael tear after vaginal birth	1.2%
Episiotomy after vaginal birth	3.5%
C-section	5.6%
No intervention of any kind	41.2%
No problems after birth	94.2% of all mothers
Transfer after birth	4.0% of all mothers
5 minutes Apgar-score ≥ 7	99.3% of all live-births
Most frequent morbidity for newborns	breathing problems
Perinatal mortality	0.17% (= 1.7‰)

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

Summary for out-of-hospital Births 2016

12,170 singleton births starting out-of-hospital (37.6% first-time mothers) were reported in 2016. 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: 4,983 home births and 7,187 births in midwife-led institutions like independent birth centres. Of all women, 16.3% were transferred during birth. 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	91.9%
Preferred birthing position	On hands and knees
Intact perineum after vaginal birth	44.8%
Third or fourth degree perinael tear after vaginal birth	1.0%
Episiotomy after vaginal birth	3.9%
C-section	5.6%
No intervention of any kind	38.7%
No problems after birth	95.1% of all mothers
Transfer after birth	3.4% of all mothers
5 minutes Apgar-score ≥ 7	99.3% of all live-births
Most frequent morbidity for newborns	breathing problems
Perinatal mortality	0.12% (= 1.2‰)

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

Summary 2015

11,039 singleton births starting out-of-hospital (39.7% first-time mothers) were reported in 2015. 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: 4,134 home births and 6,905 births in midwife-led institutions like independent birth centres. Of all women, 95.1% had no specific problems. 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	91.7%
Preferred birthing position	vertical
Intact perineum after vaginal birth	44.9%
Third or fourth degree perinael tear after vaginal birth	0.9%
Episiotomy	4.2%
C-section	5.6%
No intervention of any kind	38.7%
No problem after birth	95.1% of all mothers
Transfer after birth	3.5% of all mothers
5 minutes Apgar-score ≥ 7	99.2% of all live-births
Children's most frequent morbidity	breathing problems
Perinatal mortality	0.14% (= 1.4‰)

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

Summary 2014

11,157 singleton births starting out-of-hospital (39.8% first-time mothers) were reported in 2014. 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)