Home Birth in Portugal-A Comprehensive Analysis Based on Official Statistical Data

To date, there are no comprehensive analyses of the official data on home births in Portugal that consider other determinants beyond place of birth, such as the conditions in which births occur or the mothers' social profiles. The aims of this article were: (1) to describe the characteristics of childbirth in Portugal according to the place of birth, and (2) to analyse the association between home birth assistance and perinatal, neonatal, and infant mortality rates. We performed a descriptive, correlational analysis of the official datasets of live births in Portugal (census-based) produced by the National Institute of Statistics. In 2020, home births had more similarities with hospital births than to births occurring in any "other place". Furthermore, considering the 1995-2020 timeframe, home births with specialised assistance were negatively correlated with perinatal, neonatal, and infant mortality, and home births with non-specialised professional assistance or those that were unassisted showed a positive correlation with these mortality rates. Home births are heterogenous, and merely referencing the place of birth does not provide enough information. Although it recommended further investigation, this analysis pointed to the need to assure a specific, systematic evaluation of the quality of care in home births that allows for the consistent assessment and improvement of its safety.