PERINATAL-MORTALITY IN-HOME BIRTHS IN RURAL TANZANIA

Objective: To compare perinatal mortality, stratified for risk level, in home births attended by a relative or traditional birth attendant w ithout formal training with births attended by trained personnel in a dispensary or hospital. Study design: A prospective community based st udy in five villages in Northwestern Tanzania during 1990, involving 2 22 women delivering at home and 199 in a dispensary or hospital. Resul ts: Twenty-two of the 29 (76%) perinatal deaths occurred in home birth s. Perinatal mortality, stratified for risk level, was three times hig her in home births than it was in births in dispensaries or in hospita l (Mantel-Haenszel odds ratio, 3.29; 95% CI, 1.28-9.22). Conclusions: This study re-emphasises that all births should be attended by adequat ely trained personnel. More effective strategies are needed to convinc e women with high risk pregnancies to deliver in hospital. Emergency r eferral sec-vices are required to deal with unexpected complications a rising in low risk births at home.