Date Published: 15 February 2009

Fewer Adverse Outcomes with Private Hospital Births

Women giving birth in private hospitals and their babies are less likely than those admitted to public hospitals to suffer from a range of important complications. These are the findings of a study published online by the Medical Journal of Australia, ahead of print publication, entitled, Adverse outcomes of labour in public and private hospitals in Australia: a population-based descriptive study.

Private hospitals have been criticised in recent times for high rates of obstetric intervention such as induction of labour and caesarean section, but there have been few studies on whether this makes any difference for mothers and their babies.

Using national data for 789 240 full-term births over a recent 4-year period, almost a third of which took place in private hospitals, Associate Professor Stephen Robson, of the Australian National University Medical School, and his colleagues, Elizabeth Sullivan and Paula Laws from the Perinatal and Reproductive Epidemiology Research Unit, University of New South Wales, found that women giving birth in public hospitals had more than twice the rate of severe perineal tearing, and their babies were also more than twice as likely to require high-level resuscitation at birth. Low Apgar scores (indicating possible health problems) and intensive care admission were also more common in babies born in public hospitals. Neonatal death rates were 1 in 1000 in private hospitals and 3 in 1000 in public hospitals.

“It is a long-held orthodoxy that increased rates of obstetric intervention are “bad” for women and their babies. Our results show that although the model of obstetrician-led care [in private hospitals] is characterised by increased rates of intervention, outcomes for women with a single baby delivered at term are no worse, and further studies may determine there are benefits for women and their babies”, said Dr Robson, commenting on the study’s findings.

He acknowledged that some factors not examined by the study, such as some maternal health problems and socioeconomic status, may be contributing to the observed differences in outcome, and that further research is needed to determine the ideal model of pregnancy care.

“We hope that the results of this population-based study will stimulate further research into the effect of different models of intrapartum care on pregnancy outcome”, he said.

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