Risk of Childbirth Complications Higher With Delivery on Weekends, Nights, Holidays: Study

Giving birth on a weekend, at night, or on a holiday appears to increase the risk of delivery complications, according to the findings of new research.

In a study published last month in Risk Analysis: An International Journal, researchers evaluated data on more than 2 million deliveries, finding that the risk of childbirth complications was not only increased during off-hours, but that the rate of serious problems was also higher among women giving birth at a teaching hospital.

Researchers reviewed records from the Texas Department of State Health Services to evaluate outcomes for women with a single birth between 2005 and 2010, who were more than 20 weeks pregnant and had a normal labor onset. The study looked at labor or delivery complications, including third-or fourth-degree perineal laceration, ruptured uterus, unplanned hysterectomy, admission to intensive care unit and unplanned operating room procedure following delivery.

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More than 700 women die each year in the United States from serious, but preventable complications during delivery and childbirth. In fact, the United States has one of the worst maternal death rates of any industrialized nation, other than Mexico, according to a 2016 study. Rates of death during childbirth are comparable to those in Ukraine and Iran.

This latest study concluded that the number of birth complications increases on nights, weekends, holidays, and also increases at teaching hospitals.

“Across an ensemble of hospital situations where clinical quality is known to vary independently of patient characteristics and volume, we see corresponding variation in the risk of preventable harm to expectant mothers,” said Sammy Zahran, an associate professor of demography at Colorado State University and lead author of the study.

The risk of experiencing a complication during labor increases 21% if a mother gives birth at night. That risk increases nearly 2% for each additional hour into the night shift. Similarly, the risk of complications increases by nearly 9% if a mother delivers on a weekend.

More so, if a mother delivers on a holiday, like Christmas, New Year’s Eve, or Fourth of July, the risk of suffering a serious complication jumps 29%.

Mothers are also 2.2 times more likely to experience a complication in teaching hospitals compared to a community hospital. That risk also increases further by 1.3 times in July when a new group of residents join the staff rotation. However, the risk begins to drop slightly as the residents receive training and evens out by June.

More than 4 million women give birth in hospitals in the United States each year. However, according to a 2015 study, women in the U.S. are four times more likely to die during childbirth than women in Greece, Iceland, or Poland.

Researchers involved in this new study emphasize the importance of obstetric team work. They warn poor teamwork can be blamed for nearly 75% of preventable medical errors. Study authors also hypothesize hospitals can reduce the risk of complications and maternal death during childbirth by emphasizing scheduling inexperienced doctors with more senior physicians and health professionals.


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