Birth Weight and Prematurity in Copenhagen 1927. Health at Birth Explored in Midwife Records From Home Births and Births at the Royal Maternity Hospital

Abstract

This study examines two key indicators on perinatal health — birth weight and prematurity — based on 1,151 home births in Copenhagen in 1927, attended by trained, examined, authorized midwives, who had to call in a physician to assist in cases of complicated births. This is a 17% sample of all home births in the city, which comprises two thirds of all births in Copenhagen for that year. To compare, we also examine 398 hospital births, equal to a 10% sample of all births at the Royal Maternity Hospital for the same year. The findings reveal significant differences between home and hospital births in infant health at birth, attributable to the selective nature of hospital admissions. Hospital births revealed an average birth weight of 300 grams lower than home births and a preterm rate of more than four times as high (33% vs. 7%). The study is based on midwife birth registers in which Danish midwives registered details of every birth they attended. A nearly complete collection of these birth registers 1861–1978 is preserved at the Danish National Archives. This is a pilot study meant to explore the possibilities for further studies in this extensive source for individual birth information, of which our sample constitutes only a tiny part. But already we can see not only differences between hospital and home births but also different individual profiles in the clientele and the practices of the midwives. This shows the need for careful analysis before interpreting differentials in historical health data registered in different settings.