Home delivery and neonatal mortality in North Carolina

JAMA. 1980 Dec 19;244(24):2741-5.


Neonatal mortality examined by place and circumstances of delivery in North Carolina during 1974 through 1976 with attention given to home delivery. Planned home deliveries by lay-midwives resulted in three neonatal deaths per 1,000 live births; planned home deliveries without a lay-midwife, 30 neonatal deaths per 1,000 live births; and unplanned home deliveries, 120 neonatal deaths per 1,000 live births. The women babies were delivered by lay-midwives were screened in county health departments and found to be medically at low risk of complication, despite having demographic characteristics associated with high-risk of neonatal mortality. Conversely, the women delivered at home without known prenatal screening or a trained attendant had low-risk demographic characteristics but experienced a high rate of neonatal mortality. Planning, prenatal screening, and attendant-training were important in differentiating the risk of neonatal mortality in this uncontrolled, observational study.

MeSH terms

  • Adult
  • Delivery, Obstetric*
  • Female
  • Fetal Death / epidemiology
  • Home Care Services / standards*
  • Humans
  • Infant Mortality*
  • Infant, Newborn*
  • Maternal Mortality
  • Midwifery / standards
  • North Carolina
  • Pregnancy
  • Risk