A retrospective study of unplanned out-of-hospital deliveries


Our objective was to determine maternal characteristics and perinatal outcome of unplanned unattended deliveries en route to the hospital in comparison to unplanned deliveries attended by medical personnel within the parking facility of the hospital. All singleton deliveries occurring between 1988 and 1999 were analyzed from the computerized perinatal database. Maternal characteristics and pregnancy outcome of unattended, unplanned out-of-hospital births were compared with unplanned deliveries in the hospital parking lot, with the assistance of medical personnel. Out of 2328 out-of-hospital deliveries, 5.7% (n=133) were managed by medical personnel in the parking lot and 94.3% (n=2195) occurred en route to the hospital. The birth weight of newborns from the attended out-of-hospital delivery group was significantly higher than the comparison group (3126.2±516 g vs. 3019±522 g; P=0.023). A significant linear association was found between birth weight and attended out-of-hospital births (Mantel-Haenszel test for linear association; P=0.002). Moreover, these newborns were significantly more likely to be large for gestational age (OR=2.2, 95% CI 1.2–3.9; P=0.004). Parturients who delivered in the parking lot with the assistance of medical personnel, had significantly higher rates of grade 2 perineal tears (OR=8.4, 95% CI 1.1–5.4; P=0.041). Perinatal mortality was non-significantly higher among attended out-of-hospital deliveries (OR=2.8, 95% CI 0.8–8.3; P=0.279) as compared to unattended out-of-hospital deliveries. The attendance of medical personnel in unplanned out-of-hospital deliveries did not influence the birth outcome.

This is a preview of subscription content, log in to check access.

We’re sorry, something doesn't seem to be working properly.

Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.


  1. 1.

    Bateman DA, O'Bryan L, Nicholas SW, Heagarty MC (1994) Outcome of unattended out-of-hospital births in Harlem. Arch Pediatr Adolesc Med 148:147–152

    Google Scholar 

  2. 2.

    Bhoopalam PS, Watkinson M (1991) Babies born before arrival at hospital. Br J Obstet Gynaecol 98:57–64

    Google Scholar 

  3. 3.

    Burnett CA III, Jones JA, Rooks J, Chen CH, Tyler CW Jr, Miller CA (1980) Home delivery and neonatal mortality in North Carolina. JAMA 19:2741–2745

    Google Scholar 

  4. 4.

    Chen CC, Huang CB, Chung MY (2000) Unexpected delivery before arrival at hospital: an observation of 18 cases. Changgeng Yi Xue Za Zhi 23:205–210

    Google Scholar 

  5. 5.

    Davey DA, MacGillivary I (1988) The classification and definition of hypertensive disorders of pregnancy. Am J Obstet Gynecol 158:892–898

    Google Scholar 

  6. 6.

    Declercq ER (1984) Out-of-hospital births, U.S., 1978: birth weight and Apgar scores as measures of outcome. Public Health Rep 99:63–73

  7. 7.

    Goldenberg RL, Hale CB, Houde J, Humphrey JL, Wayne JB, Boyd BW (1983) Neonatal deaths in Alabama. III. Out-of-hospital births, 1940–1980. Am J Obstet Gynecol 15:687–693

    Google Scholar 

  8. 8.

    Hinds MW, Bergeisen GH, Allen DT (1985) Neonatal outcome in planned vs. unplanned out-of-hospital births in Kentucky. JAMA 15:1578–1582

    Google Scholar 

  9. 9.

    Janssen PA, Holt VL, Myers SJ (1994) Licensed midwife-attended, out-of-hospital births in Washington state: are they safe? Birth 21:141–148

    Google Scholar 

  10. 10.

    Leiberman JR, Fraser D, Weitzman S, Glezerman M (1993) Birthweight curves in southern Israel populations. Isr J Med Sci 29:198–203

    Google Scholar 

  11. 11.

    Meir A (1997) As nomadism ends. The Israeli Bedouin of the Negev. Westview Press, Boulder, Colorado

  12. 12.

    Moscovitz HC, Magriples U, Keissling M, Schriver JA (2000) Care and outcome of out-of-hospital deliveries. Acad Emerg Med 7:757–761

    Google Scholar 

  13. 13.

    National Center for Health Statistics (1990) Prevention profile, health, United States, 1989. US Public Health Services, Hyattsville, p 35

  14. 14.

    Sheiner E, Shoham-Vardi I, Weitzman D, Gohar J, Carmi R (1998) Decisions regarding pregnancy termination among Bedouin couples referred to third level ultrasound clinic. Eur J Obstet Gynecol Reprod Biol 76:141–146

    Google Scholar 

  15. 15.

    Sheiner E, Shoham-Vardi I, Sheiner EK, Mazor M, Katz M, Carmi R (1999) Maternal factors associated with severity of birth defects. Int J Gynecol Obstet 64:227–232

    Google Scholar 

  16. 16.

    Sheiner EK, Sheiner E, Shoham-Vardi I, Mazor M, Katz M (1999) Ethnic differences influence caregiver's estimates of pain during labor. Pain 81:299–305

    Google Scholar 

  17. 17.

    Verdile VP, Tutsock G, Paris PM, Kennedy RA (1995) Out-of-hospital deliveries: a five-year experience. Prehosp Disaster Med 10:10–13

    Google Scholar 

  18. 18.

    Viisainen K, Gissler M, Hartikainen AL, Hemminki E (1999) Accidental out-of-hospital births in Finland: incidence and geographical distribution 1963–1995. Acta Obstet Gynecol Scand 78:372–378

    Google Scholar 

  19. 19.

    Walraven GE, Mkanje RJ, Roosmalen J, van Dongen PW, Dolmans WM (1995) Perinatal mortality in home births in rural Tanzania. Eur J Obstet Gynecol Reprod Biol 58:131–134

    Google Scholar 

  20. 20.

    White P (1978) Classification of obstetric diabetes. Am J Obstet Gynecol 130:228–230

    Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Eyal Sheiner.

Additional information

Presented in part at the XVIII European Congress of Perinatal Medicine, Oslo June 19–22, 2002

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Sheiner, E., Hershkovitz, R., Shoham-Vardi, I. et al. A retrospective study of unplanned out-of-hospital deliveries. Arch Gynecol Obstet 269, 85–88 (2004). https://doi.org/10.1007/s00404-002-0426-0

Download citation


  • Unplanned out-of-hospital delivery
  • Unattended delivery
  • Perinatal mortality
  • Large-for-gestational age