Abstract:
Background: Perinatal mortality is a rare outcome among babies born at term in
developed countries after normal uncomplicated pregnancies; consequently, the numbers involved in
large databases of routinely collected statistics provide a meaningful evaluation of these uncommon
events. The National Perinatal Data Collection records the place of birth and information on the
outcomes of pregnancy and childbirth for all women who give birth each year in Australia. Our
objective was to describe the perinatal mortality associated with giving birth in ‘‘alongside hospital’’
birth centers in Australia during 1999 to 2002 using nationally collected data. Methods: This
population-based study included all 1,001,249 women who gave birth in Australia during 1999 to
2002. Of these women, 21,800 (2.18%) gave birth in a birth center. Selected perinatal outcomes
(including stillbirths and neonatal deaths) were described for the 4-year study period separately for
first-time mothers and for women having a second or subsequent birth. A further comparison was
made between deaths of low-risk term babies born in hospitals compared with deaths of term babies
born in birth centers. Results: The total perinatal death rate attributed to birth centers was
significantly lower than that attributed to hospitals (1.51/1,000 vs 10.03/1,000). The perinatal
mortality rate among term births to primiparas in birth centers compared with term births among lowrisk
primiparas in hospitals was 1.4 versus 1.9 per 1,000; the perinatal mortality rate among term
births to multiparas in birth centers compared with term births among low-risk multiparas in hospitals
was 0.6 versus 1.6 per 1,000. Conclusions: This study using Australian national data showed that the
overall rate of perinatal mortality was lower in alongside hospital birth centers than in hospitals
irrespective of the mother’s parity.
