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December 19, 1980

Home Delivery and Neonatal Mortality in North Carolina

Author Affiliations

From the Family Planning Evaluation Division, Center for Disease Control, Atlanta (Drs Burnett and Tyler and Ms Rooks); the Maternal and Child Health Branch, Division of Health Services, State of North Carolina, Raleigh (Mr Jones); the Department of Biostatistics, Emory University, Atlanta (Ms Chen); and the Department of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill (Dr Miller). Dr Burnett is currently director, Northeast Health District, Georgia Department of Human Resources, Athens. Ms Rooks is currently expert consultant with the Office of the Surgeon General, Washington, DC.

JAMA. 1980;244(24):2741-2745. doi:10.1001/jama.1980.03310240033019

Neonatal mortality is 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 whose 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 attendanttraining were important in differentiating the risk of neonatal mortality in this uncontrolled, observational study.

(JAMA 1980;244:2741-2745)