Is It More Dangerous To Give Birth In A Hospital On The Weekend?

In a hospital setting, is it more dangerous to give birth on a weekend? That’s the question that was examined in a new study published in the BMJ. There has been some research and plenty of anecdotal evidence to suggest that it is less safe to give birth in a hospital on the weekend rather than on a weekday. The weekend effect has been examined across many research disciplines in the past and in many industrialized nations. It’s even been examined across a range of health outcomes, but the extent of the weekend effect on giving birth has never been examined to demonstrate the fullest scope of the higher risks involved in giving birth at a hospital on the weekend.

According to the newly released article in the BMJ, there is a higher rate of complications for both babies and for the women giving birth to them if the expectant mothers are admitted during the weekend. The expansive study examined data from more than one million patients in hospitals in England over a two-year time period. Medical News Today called the results “worrying.”

“Researchers found a significant increase in a number of negative health outcomes for expectant mothers admitted to hospitals on Saturdays and Sundays.”

Although the weekend effect has been deemed controversial, the latest investigation points towards associations between the day of delivery and the quality of care that women and babies are given. There are, of course, a multitude of factors that needed to be considered when researchers examined the weekend effect on labor and delivery. Medical News Today points out a parallel in a study into acute myocardial infarctions in 922,074 elderly American patients. Weekend hospitalizations resulted in a comparatively elevated one-year mortality rate in that scenario as well.

The study published in the BMJ involves the most comprehensive examination of data to date and was conducted by a research team from Imperial College London. The researchers analyzed data from 1,332,835 deliveries and 1,349,599 births within the English National Health Service that occurred between April 2010 and March 2012. It even compared measures of quality and the safety of maternity services. The team looked at perinatal mortality, emergency readmissions into the hospital, infections, birth injuries, and perineal tears, among other factors.

According to the research, most babies are born on Thursdays, and the fewest number of babies are born on Sundays. After adjusting for mother’s age, ethnicity, previous cesarean sections, socioeconomic factors, diabetes, pre-eclampsia, blood pressure, eclampsia, and other conditions, the team discovered that babies born on weekends had higher rates of death, injury, and readmission, and mothers had higher rates of infections than their weekday counterparts. There was almost one additional infant that died within a week of delivery for every thousand babies born on the weekend, than babies born on weekdays. The weekend effect, according to the researchers, is likely responsible for 770 additional perinatal deaths in the country each year. This means that the weekend effect on birth and delivery claimed more lives in England than measles in 1945.

Though it seemed logical to jump to staffing issues as a cause, Prof. Paul Aylin, from the School of Public Health at Imperial College, London, the senior academic on the research team, said they found no correlation between staffing levels and perinatal death or injuries at all. There is a multitude of other factors. Could the number of visitors a newborn receives increase on the weekend, thus limiting maternal bonding time? Could weekend visitors during labor cause more complications? There are more things to consider than just staff error.

U.S. obstetrics experts Jonathan Snowden and Aaron Caughey blame the higher risks of weekend births on “capacity strain.” Capacity strain is described as the effects of declining performance that a unit might exhibit once a certain threshold of patient volume or complexity of care is reached. As noted by the researchers, though, there are a multitude of factors to consider when examining potential causes for the higher risks from birthing on the weekend, and more study into possible causes is warranted.

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