Child Orthopedics

Frequently Asked Questions

I had a home birth with my second child. It turns out she has hip dysplasia. Could this have been avoided with a hospital birth?

Hip dysplasia also known as developmental dysplasia of the hip or DDH refers to a hip deformity that can result in hip dislocation. The hip socket is shallow allowing the hip to slide up and out. This slippage is called a hip subluxation.

In the case of subluxation, the top or head of the femur (thigh bone) remains in contact with some part of the acetabulum or hip socket. Dislocation occurs when the femoral head is completely out of the socket.

Risk factors for the development of DDH include a positive family history of DDH and breech position at birth. You didn't mention if either of those describe your situation. Other risk factors include female sex, growth problems while inside the mother's uterus, older age of the mother, and high birth weight of the child.

None of these are related to having a home birth. The condition may have been identified faster in a hospital but a midwife or birth assistant can easily perform tests for hip dysplasia at birth and during well-baby check ups.

Nicola M. Portinaro, MD, MSc, FRCS. The Role of Ultrasonography in the Diagnosis of Developmental Dysplasia of the Hip. In Journal of Pediatric Orthopaedics. March 2007. Vol. 27. No. 2. Pp. 247-250.

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