Perinatal outcome in hospital and birth center obstetric care

Objective: Our purpose was to compare birth complications and fetal outcome in hospitals and birth centers. Method: We retrospectively compared all 801 deliveries between 1992 and 1994 from two free-standing birth centers against 3271 hospital deliveries in Berlin. The hospital collective was selected according to the same risk criteria of the birth centers. Results: The birth center group had significantly fewer medical interventions, with a similar cesarean section rate (3.0% vs. 4.6%, P = 0.057) and occurrence of severe perineal lesions. The episiotomy rate was significantly higher (P < 0.001) in the clinics for first time and multiple births. The perinatal mortality was not significantly different (< 0.1 per 1000). One-minute Apgar scores less than 7 were found significantly more often in the birth center group. Conclusion: When birth centers employ thorough risk selection and significant early referralrates to nearby hospitals, there is no evidence of increased maternal or perinatal risk compared to hospital deliveries. (C) 1999 International Federation of Gynecology and Obstetrics.