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Babies born at home are 2.4 times likelier to die within the first month of life than babies born in hospitals, new research suggests.

A study published Wednesday in the New England Journal of Medicine surveyed the outcomes of some 80,000 births in Oregon, and found that an average of 3.9 babies per 1,000 born in planned home deliveries died during birth or the first month of life, compared to only 1.8 per 1,000 babies born in hospitals. Out-of-hospital births were also associated with an increased risk of neonatal seizures, the researchers found. 

On the other hand, home births were associated with drastically higher rates of unassisted vaginal delivery, with 93.8 percent of home births proceeding without surgical intervention versus 71.9 percent of hospital births. Home births were further correlated with lower odds of obstetrical procedures all around. 

Despite the study’s somewhat troubling implications for mothers who elect to give birth outside of hospitals, the study’s authors also emphasized that absolute rates of perinatal death are extremely low in both home and hospital births.