More born outside hospital

children born outside hospitals Björn Gunnarsson fellow member Norwegian Air Ambulance Foundation. Incubator born outside hospitalMore needs to be done to reduce the number of children born outside hospitals, says Björn Gunnarsson, fellow member of the Norwegian Air Ambulance Foundation. Photo: Fredrik Naumann / Felix Features

More born outside hospital

Every year 400 children are born outside hospital. The mortality rate for these children is more than twice as high as for those born in hospitals, according to research from the Norwegian Air Ambulance Foundation.


They emerge into the world in ambulances, private cars and taxis on their way to hospitals. Or home on the bathroom floor. Norway has 50 birth institutions and 9% of Norwegian women live an hour or more away from such an institution. More than twice as many than 30 years ago, give birth outside hospitals.

– Centralization of natal care is a good thing. It is much safer to give birth in Norway than 30 years ago, but many have a long journey to a clincic. Unplanned births are therefore not always possible to prevent, says fellow Björn Gunnarsson in the Norwegian Air Ambulance Foundation.

On December 8 he disputes his doctoral and presents findings regarding the risk of being born outside the hospital. In the dissertation “Unplanned Out-of-Institution Births: Incidence, Outcome, and Prediction of Immediate Childbirth”, Gunnarsson and his research team have analyzed material from the Medical Birth Register ranging from 1999 to 2013.

– One of the most important findings we have made is that mortality for children born outside hospitals is more than twice as high as for those born in hospitals. This is a topic that has received little attention in Norway. We need to focus on unplanned births outside hospitals and try to figure out how to reduce the numbers, says Gunnarson.

Most unplanned births in rural Norway

More than 6,000 children have been born outside a birth clinic in Norway in the last 15 years – an average of more than 400 a year. That is almost twice as many as in 1980.

– Causes of death vary. It is rarely about systemic failure in the prehospital chain. Necessary equipment and staff were available. In most cases, the cause of death was related to infections, prematurity, disease in the placenta or because the mother did not seek the required medical care, says Gunnarsson.

Gunnarsson’s research shows that the majority of those who give birth outside hospitals live in rural Norway and are young women who have given birth to more than one child before.

– Living in a remote area often involves long journeys between home and the maternity clinic, and the risk of birth before reaching a birth institution is therefore bigger. At the same time, birth is often very quick with someone who has birthed before, says Gunnarsson.

Centralization necessary

Nevertheless, he believes that the centralization of birth care has been both reasonable and necessary.

– Centralization has given larger and more specialized birth clinics and increased expertise, which in turn has resulted in the mortality rate for children born at institutions has decreased year by year, says Gunnarsson.

He believes that more needs to be done to reduce the number of children born outside clinics without being planned.

– We must now focus more on births outside hospitals and try to figure out how to reduce the numbers.


©  Norwegian Air ambulance / Norway Today