When we restricted the home - birth group to women who actually gave birth at home, the rates of adverse maternal and newborn outcomes did not differ significantly from
those among all planned home births.
Previous research from the UK and Canada has identified a lower risk of PPH
among planned home births than among planned hospital births [4, 11], but the UK study did not attempt to control for confounding variables.
Future research should also attempt to establish whether or not these results also apply to more life - threatening categories of PPH (e.g. > 1,500 ml of blood lost), and whether the lower incidence of PPH
among planned home births translates to fewer cases of PPH - related severe morbidity.
Among parous women the rates of Apgar scores below seven and NICU admissions were significantly lower
among planned home births (NICU admissions up to 28 days, 1.36 versus 1.95 %, aOR 0.79, 95 % CI: 0.66 to 0.93).
International comparison of perinatal mortality (stillbirth and first week deaths according to WHO definitions)
among planned home births starting labour at home
The most recent large scale study comparing outcomes for mother and baby reported in the British Medical Journal last month showed that for women who had previously given birth, adverse outcomes were less common
among planned home births (1 per 1,000) than among planned hospital births (2.3 per 1,000).
Therefore, the personnel, training, and equipment available for neonatal resuscitation represent other possible contributors to the excessive neonatal mortality rate
among planned home births» (Wax et al, 2010, p 243.
Not exact matches
0/1000 Sweden 1992 - 2004 (25): «There were no emergency cases
among 790
planned home birth group.
What the authors should have told us was that there were two neonatal deaths (0.11 %)
among women
planning a
home birth and four (0.03 %) from women
planning to give
birth in the hospital.
In the latest paper discussed in that post, Severe adverse maternal outcomes
among low risk women with
planned home versus hospital
births in the Netherlands: nationwide cohort study, de Jonge concluded:
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.»
Supported by funding from the Canadian Institute for Health Research, Professor Vedam conducted a national, mix - methods study on factors leading to divergent attitudes
among maternity care providers» regarding
planned home birth.
Study results provide evidence that mortality outcomes in
planned home birth are not significantly different compared to
planned hospital
birth,
among 693,592 women with singleton
births in the Netherlands.
Her latest effort is Severe adverse maternal outcomes
among low risk women with
planned home versus hospital
births in the Netherlands: nationwide cohort study.
If so, this self selection may have resulted in better outcomes
among women with
planned home birth.
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 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.
de Jonge A, Mesman JA, Manniën J, Zwart JJ, van Dillen J, van Roosmalen J. Severe adverse maternal outcomes
among low risk women with
planned home versus hospital
births in the Netherlands: nationwide cohort study.
But a comparison of «low - risk» women who
planned to give
birth at
home with those who
planned to give
birth in hospital with a midwife found no difference in death or serious illness
among either baby or mother.
Perinatal mortality and morbidity up to 28 days after
birth among 743,070 low - risk
planned home and hospital
births: A cohort study based on three merged national perinatal databases.
Women and their partners should be advised that the risk of PPH is higher
among births planned to take place in hospital compared to
births planned to take place at
home, but that further research is needed to understand (a) whether the same pattern applies to the more life - threatening categories of PPH, and (b) why hospital
birth is associated with increased odds of PPH.
These findings follow earlier research by Janssen that demonstrated that
planned home births resulted in fewer interventions and similar rates of adverse newborn outcomes compared to
planned hospital
births among women who met the criteria for
home births.
A new study tracking the safety of
home birth in the United States has taken a major step in that direction, its authors believe, finding that outcomes
among women who had
planned, midwife - led
home births were «excellent,» and that the women experienced relatively low rates of intervention.
The relative safety of
planned home births is a topic of continuous debate, but studies have so far been too small to compare severe maternal complications between
planned home and
planned hospital
birth among low risk women.
The aim of this study is to compare the odds of postpartum haemorrhage
among women who opt for
home birth against the odds of postpartum haemorrhage for those who
plan a hospital
birth.
In today's peer - reviewed Journal of Midwifery & Women's Health (JMWH), a landmark study confirms that
among low - risk women,
planned home births result in low rates of interventions without an increase in adverse outcomes for mothers and babies.
«
among low - risk women,
planned home births result in low rates of interventions without an increase in adverse outcomes for mothers and babies.»
But the overall risks to the baby remained small regardless of the
birth plan — there were about two deaths per 1,000
births among planned hospital
births, vs. four deaths per 1,000
births planned at
home or in birthing centers.
Here is what I am referring to in the study: «The intrapartum fetal death rate
among women
planning a
home birth in our sample was 1.3 per 1000 (95 % CI, 0.75 - 1.84).
Among births at
home from 2004 - 2005 (
planned plus unplanned) there was an increase from 0.56 % to 0.59 %; there was no increase from 2005 - 2006.
The risk of all adverse maternal outcomes assessed was significantly lower
among the women who
planned a
home birth than
among those who
planned a physician - attended hospital
birth (Table 3).
23 Therefore, the higher rate of admission (or readmission if a hospital
birth)
among newborns in the
planned home -
birth group than of readmission in the
planned hospital -
birth group may have been linked to the need for treatment of hyper - bilirubinemia, which,
among babies born in hospital, may require a longer stay in hospital rather than readmission.
The following study was the largest
home birth study done in the U.S.
Among 16,924 women who
planned home births at onset of labor 89 % gave
birth at
home, 11 % transferred to the hospital, 5.2 % had a c - section.
Results: The rate of perinatal death per 1000
births was 0.35 (95 % confidence interval [CI] 0.00 — 1.03) in the group of
planned home births; the rate in the group of
planned hospital
births was 0.57 (95 % CI 0.00 — 1.43)
among women attended by a midwife and 0.64 (95 % CI 0.00 — 1.56)
among those attended by a physician.
The rate of perinatal death per 1000
births was 0.35 (95 % confidence interval [CI] 0.00 - 1.03) in the group of
planned home births; the rate in the group of
planned hospital
births was 0.57 (95 % CI 0.00 - 1.43)
among women attended by a midwife and 0.64 (95 % CI 0.00 - 1.56)
among those attended by a physician.
RESULTS: The rate of perinatal death per 1000
births was 0.35 (95 % confidence interval [CI] 0.00 - 1.03) in the group of
planned home births; the rate in the group of
planned hospital
births was 0.57 (95 % CI 0.00 - 1.43)
among women attended by a midwife and 0.64 (95 % CI 0.00 - 1.56)
among those attended by a physician.
The intrapartum and neonatal mortality
among women considered at low risk at start of labour, excluding deaths concerning life threatening congenital anomalies, was 1.7 deaths per 1000
planned home births, similar to risks in other studies of low risk
home and hospital
births in North America.
«A Dutch study of more than 500,000 women reported that
planning a
home birth does not increase the risks of perinatal mortality and severe perinatal morbidity
among low risk women provided they were supported by well trained midwives and a good transportation and referral system» (quote article 24).
Including these women
among hospital
births would bias the results of
planned hospital
births negatively and
home births positively.
Percentage non-optimal characteristics in the perinatal background index
among planned home and
planned hospital
births in primiparous and multiparous women
Several studies [13 — 19] have found reduced obstetric interventions and optimal outcomes
among healthy women who
planned to give
birth at
home or a
birth centre under the care of midwives.