Are Birth Injuries More Likely During Non-Hospital Deliveries?

Where you give birth is an important factor when planning for your baby. Nearly 99 percent of deliveries occur in hospitals. But more mothers are using alternative options. These include giving birth at home or in a birthing center, which the American College of Obstetricians and Gynecologists (ACOG) defines as a freestanding non-hospital facility aiming to provide a more natural, non-clinical experience. Birthing center births nearly doubled between 2007-2019, and CDC data from 2022 showed a 56 percent increase in home births since 2016.

However, studies show that birthing centers are associated with an increased risk of complications like seizures, neonatal death, and low Apgar scores. And while midwife-assisted home birth has many advantages, babies born at home are twice as likely to die as those in hospitals.

The stakes are even higher for mothers in three particular high-risk situations. The ACOG says mothers who have previously given birth via C-section, are having multiple babies, or are having a baby who is not in a head-down position should never give birth outside a hospital. Those who are over 35 or have diabetes and/or high blood pressure should also stick with a hospital.

While some birthing centers have obstetrician-gynecologists (OB-GYNs) on staff, midwives are typically the main providers there and during a home birth. While midwives are licensed professionals, they are not doctors. There are three types of midwives: certified professional midwives, who don’t have hospital privileges and learn through apprenticeships; certified midwives, who have graduate degrees but no nursing license; and certified nurse midwives, who have graduate degrees and nursing licenses. 

Regardless of where you choose to give birth, you and your baby deserve to feel safe throughout the labor and delivery process. Midwives and birthing centers, like negligent medical doctors or hospitals, can be sued through a birth injury lawsuit if their failure to meet the standard of care leads to an injury.

Choosing a Location for Your Child’s Delivery 

Many mothers choose to give birth at home or in a birthing center for cultural or religious reasons, lack of trust in or affordability of hospitals, or simply because they prefer the comforts of home. Women of color are especially susceptible to poorer treatment in hospitals and often find birthing centers more compassionate. The maternal mortality rate for Black women more than doubled between 1999-2019.

The ACOG says hospitals are the safest overall option, especially for high-risk pregnancies. But there are pros and cons to home births, birthing centers, and hospitals. If you are considering giving birth at home or a birthing center, you should consult with your healthcare provider before making a decision.

Hospital Pros

• OB-GYNs supervise the birth, allowing for C-sections, induced labor, and other unexpected scenarios
• Access to epidurals and other pain relief
• Constant fetal monitoring to predict and prevent a birth injury
• Neonatal care for complications after birth

Hospital Cons

• Sterile, unfamiliar, and often chaotic environment
• Having to share a room with another laboring mother or limit family members
• Most expensive option, especially if you are uninsured

Birthing Center Pros

• Soothing and natural environment 
• Ability to limit or refuse prescription drugs
• Freedom of movement, with options like standing up or using a birthing pool
• Anyone you want can be present
• Many centers work with teams of OB-GYNs; some have them on-call
• Lower rates of interventions such as forceps delivery, C-sections, or need for the NICU 

Birthing Center Cons

• OB-GYNs are typically not on-site
• Limited options for pain relief
• Might need to transfer to a hospital within minutes if complications arise

Home Birth Pros

• Being in the comfort of your own home
• No medical interventions if birth goes smoothly
• Complete control over the birthing process and comfort measures
• Lower cost when there is limited hospital access
• Ability to choose a midwife and create a custom birth plan

Home Birth Cons

• Highest risk of complications and lack of access to emergency care
• Dangerous for any pregnancy at higher than normal risk
• Requires heavy preparation and reliance on the expertise of midwives

If choosing a birthing center or home birth, make sure to research the center or chosen midwife; licensing requirements and rules vary widely by state. 

Filing a Birth Injury Lawsuit

Sadly, birth injuries can happen in any setting and may be due to unavoidable mistakes or gross negligence. Some of the most common birth injuries include:

• Cerebral palsy – typically caused by oxygen deprivation after delayed medical intervention
• Brachial plexus injury – nerve damage often resulting from rough or improper infant handling
• Traumatic brain injury – commonly caused by unnecessarily prolonged delivery or misusing delivery tools like forceps
• Fractures or breaks – often occurring in the skull, collarbone, or clavicle

Many of these injuries can lead to multiple surgeries, long-term pain, or permanent disability. 

Because midwives aren’t always required to carry malpractice insurance and state laws can be vague about their obligations, birth injury lawsuits stemming from a home or birthing center labor and delivery can be extremely complicated.  

The birth injury team at Paulson & Nace has the experience to pursue compensation on your behalf. If you or your child were harmed during birth due to medical negligence, we can help you recover damages like medical bills, pain and suffering, loss of enjoyment of life, and more. Call us anytime at 202-463-1999 or visit us online to schedule your free, no-obligation consultation.