The conclusion that «low - risk women» do not experience increased complications or adverse outcomes does not actually address the objective of the study which was to examine «
outcomes of planned home births.»
Using this tool we compared
the outcomes of planned home births with those of planned hospital births for primiparous and multiparous women after controlling for the confounding effects of social, medical, and obstetric background.
We highly recommend starting your research with a 2005 study published in the British Medical Journal: «
Outcomes of planned home births with certified professional midwives: large prospective study in North America».
Outcomes of planned home births with certified professional midwives: Large prospective study in North America.
In this study, we ascertained
outcomes of all planned home births attended by registered midwives in an entire health region with a single - payer universal health care system.
We compared
the outcomes of planned home births attended by midwives with those of planned hospital births attended by midwives or physicians.
Outcomes of planned home births compared to hospital births in Sweden between 1992 and 2004: a population - based register study.
Two articles will be published in the upcoming Journal of Midwifery & Women's Health: one describes the MANA Stats system and how it works, and the other describes
the outcomes of planned home births with midwives between 2004 and 2009.
The first study listed, «
Outcomes of planned home births with registered midwife versus planned hospital birth with midwife or physician» was published in the Canadian Medical Association Journal in 2009.
Neonatal
outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation.
«Kenneth C Johnson and Betty - Anne Daviss's
Outcomes of planned home births with certified professional midwives: large prospective study in North America, BMJ 2005; 330:1416 (18 June), found that the outcomes of planned homebirths for low risk mothers were the same as the outcomes of planned hospital births for low risk mothers, with a significantly lower incident of interventions in the homebirth group.»
The blog post says that one of the articles «describes
the outcomes of planned home births with midwives between 2004 and 2009.»
Outcomes of planned home births with certified professional midwives: large prospective study in North America.
Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia.
Practice Guidelines for California Licensed Midwives Best Practice Guidelines: Transfer from Planned Home Birth to Hospital Citizens for Midwifery Home Birth Facts Canadian Medical Association Journal:
Outcomes of Planned Home Birth Solace for Mothers: Informed Consent Questions to Consider when Interviewing a Doctor or Midwife
First, a little background on the study,
Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician.
«
Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician.»
Johnson & Daviss: Letter C under section III of the list of studies that the Midwives Alliance of North America deems the very best in proving home birth safety is titled, «
Outcomes of planned home birth with certified professional midwives.»
Outcomes of planned home birth with registered midwife vs. planned hospital birth with midwife or physician.
Conclusions:
The outcome of planned home births is at least as good as that of planned hospital births in women at low risk receiving midwifery care in the Netherlands.
However, the goal of this summit was not to examine, debate, or form a consensus statement regarding the evidence published regarding safety or maternal - newborn
outcomes of planned home birth.
Not exact matches
«Maternal and newborn
outcomes in
planned home birth vs
planned hospital
births: a metaanalysis» by Joseph R. Wax, MD; F. Lee Lucas, PhD; Maryanne Lamont, MLS; Michael G. Pinette, MD; Angelina Cartin; and Jacquelyn Blackstone, DO, appeared in the American Journal
of Obstetrics & Gynecology, Volume 203, Issue 3 (September 2010) published by Elsevier.
The rarity
of planned home births and particularly perinatal death in any birthing environment makes gathering a sufficient sample for ensuring a dataset large enough to offer the incidences
of rare
outcomes particularly challenging.
Outcomes of 11,788
planned home births attended by certified nurse - midwives: a retrospective descriptive study.
Explain that if they
plan birth at
home there is a small increase in the risk
of an adverse
outcome for the baby.
1.1.2 Explain to both multiparous and nulliparous women that they may choose any
birth setting (
home, freestanding midwifery unit, alongside midwifery unit or obstetric unit), and support them in their choice
of setting wherever they choose to give
birth: Advise low ‑ risk multiparous women that
planning to give
birth at
home or in a midwifery ‑ led unit (freestanding or alongside) is particularly suitable for them because the rate
of interventions is lower and the
outcome for the baby is no different compared with an obstetric unit.
... [T] here was a significant excess
of the primary
outcome in
births planned at
home compared with those
planned in obstetric units in the restricted group
of women without complicating conditions at the start
of care in labour.
Quote from the midwife site:» There was no evidence that
planned home birth among low risk women leads to an increased risk
of severe adverse maternal
outcomes in a maternity care system with well trained midwives and a good referral and transportation system.»
Fransen (2015) makes a few intriguing points: The Midwives Alliance
of North American (MANA) identifies a systematic review written within the official «journal»
of Lamaze International as one «best available studies on
planned home birth and maternal fetal
outcomes.»
Women who
planned a
home birth were at reduced risk
of all obstetric interventions assessed and were at similar or reduced risk
of adverse maternal
outcomes compared with women who
planned to give
birth in hospital accompanied by a midwife or physician.
For healthy nulliparous women with a low risk pregnancy, the risk
of an adverse perinatal
outcome seems to be higher for
planned births at
home, and the intrapartum transfer rate is high in all settings other than an obstetric unit
For the restricted sample
of women without any complicating conditions at the start
of care in labour, the odds
of a primary
outcome event were higher for
births planned at
home compared with
planned obstetric unit
births (adjusted odds ratio 1.59, 95 % confidence interval 1.01 to 2.52) but there was no evidence
of a difference for either freestanding or alongside midwifery units compared with obstetric units.
«Women with
planned home birth had lower rates
of all adverse maternal
outcomes, albeit not significantly so for nulliparous women.»
In the subgroup analysis stratified by parity, there was an increased incidence
of the primary
outcome for nulliparous women in the
planned home birth group (weighted incidence 9.3 per 1000
births, 95 % confidence interval 6.5 to 13.1) compared with the obstetric unit group (weighted incidence 5.3, 3.9 to 7.3).
Main
outcome measure A composite primary
outcome of perinatal mortality and intrapartum related neonatal morbidities (stillbirth after start
of care in labour, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus, or fractured clavicle) was used to compare
outcomes by
planned place
of birth at the start
of care in labour (at
home, freestanding midwifery units, alongside midwifery units, and obstetric units).
There was no difference overall between
birth settings in the incidence
of the primary
outcome (composite
of perinatal mortality and intrapartum related neonatal morbidities), but there was a significant excess
of the primary
outcome in
births planned at
home compared with those
planned in obstetric units in the restricted group
of women without complicating conditions at the start
of care in labour.
For nulliparous women, there is some evidence that
planning birth at
home is associated with a higher risk
of an adverse perinatal
outcome.
When the analysis was restricted to units or trusts with a response rate
of at least 85 %, the higher odds
of the primary
outcome for nulliparous women in the
planned home birth group remained, and the strength
of this association increased (appendix 5 on bmj.com).
There was no evidence that
planned home birth among low risk women leads to an increased risk
of severe adverse maternal
outcomes in a maternity care system with well trained midwives and a good referral and transportation system.
The aim
of our study was to determine firstly, whether a retrospective linked data study was a viable alternative to such a design using routinely collected data in one Australian state and secondly, to report on the
outcomes and interventions for women (and their babies) who
planned to give
birth in a hospital labour ward,
birth centre or at
home.
A study published in the British Medical Journal (July 2005)
of the
outcomes of 5,418
planned home births concluded that homebirth is a reasonable and safe choice for healthy women.
Oregon now has the most complete, accurate data
of any US state on
outcomes of births planned to occur in the mother's
home or an out -
of - hospital
birth center.
We evaluated the
outcomes of Australian
home births and compared these with all Australian
births and
planned home births elsewhere.
The study reviewed the
births of nearly 17,000 women and found that, among low - risk women,
planned home births result in low rates
of birth interventions without an increase in adverse
outcomes for mothers and newborns.
«
Planned home births result in low rates
of interventions without an increase in adverse
outcomes for mothers and babies,» Simkins boasts.
Planned birth at
home in low risk women without complicating conditions at the start
of care in labour was associated with significant cost savings and a significant decrease in adverse perinatal
outcomes avoided.
Outcomes were compared by
planned place
of birth: at
home, in freestanding midwifery units, in alongside midwifery units, or in obstetric units.
There was, however, an increased incidence
of adverse perinatal
outcome associated with
planned birth at
home in nulliparous low risk women, resulting in the probability
of it being the most cost effective option at a cost effectiveness threshold
of # 20000 declining to 0.63.
Incremental cost effectiveness ratios and net benefit statistics for normal
birth outcome in women at low risk
of complications according to
planned place
of birth:
home, freestanding midwifery unit (FMU), or alongside midwifery unit (AMU) with obstetric unit (OU) as reference
Overall, and for multiparous women,
planned birth at
home generated the greatest mean net benefit with a 100 % probability
of being the optimal setting across all thresholds
of cost effectiveness when perinatal
outcomes were considered.