Sentences with phrase «at the home birth outcomes»

The study, published in the Journal of Midwifery & Women's Health on Thursday, looked at the home birth outcomes for roughly 17,000 women as recorded in the Midwives Alliance of North America data collection system between 2004 and 2009.

Not exact matches

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.

Home birth families are generally quite aware that hospitals are full of germs, sick people, and put them at risk for poor outcomes simply because they walked through the door, but there isn't much discussion about going beyond birthing in your own to germs, to making a concerted effort to birth in a green environment.

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.

Official figures show there is a very slight risk increase of a poor outcome for women having their first baby at home - from five in 1,000 for a hospital birth to nine in 1,000 - almost 1 % - for a home birth.

Flint and colleagues suggested that when midwives get to know the women for whom they provide care, interventions are minimised.22 The Albany midwifery practice, with an unselected population, has a rate for normal vaginal births of 77 %, with 35 % of women having a home birth.23 A review of care for women at low risk of complications has shown that continuity of midwifery care is generally associated with lower intervention rates than standard maternity care.24 Variation in normal birth rates between services (62 % -80 %), however, seems to be greater than outcome differences between «high continuity» and «traditional care» groups at the same unit.25 26 27 Use of epidural analgesia, for example, varies widely between Queen Charlotte's Hospital, London, and the North Staffordshire NHS Trust.

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 planning birth in a midwifery unit and multiparous women planning birth at home experience fewer interventions than those planning birth in an obstetric unit with no impact on perinatal outcomes.

For healthy multiparous women with a low risk pregnancy, there are no differences in adverse perinatal outcomes between planned births at home or in a midwifery unit compared with planned births in an obstetric unit

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).

The latest example is an analysis prepared by faculty at the College of Public Health of the University of Arizona, Tucson and the Arizona Public Health Training Center for the Arizona Department of Health Services entitled Outcomes of Home vs. Hospital Births Attended by Midwives: A Systematic Review and Meta - analysis.

Most studies of homebirth in other countries have found no statistically significant differences in perinatal outcomes between home and hospital births for women at low risk of complications.36, 37,39 However, a recent study in the United States showed poorer neonatal outcomes for births occurring at home or in birth centres.40 A meta - analysis in the same year demonstrated higher perinatal mortality associated with homebirth41 but has been strongly criticised on methodological grounds.5, 42 The Birthplace in England study, 43 the largest prospective cohort study on place of birth for women at low risk of complications, analysed a composite outcome, which included stillbirth and early neonatal death among other serious morbidity.

Researchers reported high overall perinatal mortality in a study of home birth in Australia, 35 qualifying that low risk home births in Australia had good outcomes but that high risk births gave rise to a high rate of avoidable death at home.36 Two prospective studies in North America found positive outcomes for home birth, 23 24 but the studies were not of sufficient size to provide relatively stable perinatal death rates.

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.

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

For nulliparous low risk women, planned birth at home is still likely to be the most cost effective option but is associated with an increase in adverse perinatal outcomes.

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.

For nulliparous low risk women, planned birth at home generates incremental cost savings but increases adverse perinatal outcomes

In further analyses restricted to women without complicating conditions at the start of care in labour, the adjusted odds of adverse perinatal outcomes were higher for births planned at home compared with those planned in obstetric units (adjusted odds ratio 1.59, 95 % confidence interval 1.01 to 2.52).

There was, however, an increased incidence of adverse perinatal outcomes 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 threshold of # 20000 declining to 0.63.

Birth at home generated the greatest mean net monetary benefit with a 100 % probability of being the optimal setting across all thresholds of cost effectiveness (varied between # 0 and # 100000 for the maternal outcomes of interest).

With regards to maternal outcomes in nulliparous and 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.

For low risk women without complicating conditions at the start of care in labour, the mean incremental cost effectiveness ratios associated with switches from planned birth in obstetric unit to non-obstetric unit settings fell in the south west quadrant of the cost effectiveness plane (representing, on average, reduced costs and worse outcomes).25 The mean incremental cost effectiveness ratios ranged from # 143382 (alongside midwifery units) to # 497595 (home)(table 4 ⇓).

Since the early 1990s, government policy on maternity care in England has moved towards policies designed to give women with straightforward pregnancies a choice of settings for birth.1 2 In this context, freestanding midwifery units, midwifery units located in the same building or on the same site as an obstetric unit (hereafter referred to as alongside midwifery units), and home birth services have increasingly become relevant to the configuration of maternity services under consideration in England.3 The relative benefits and risks of birth in these alternative settings have been widely debated in recent years.4 5 6 7 8 9 10 Lower rates of obstetric interventions and other positive maternal outcomes have been consistently found in planned births at home and in midwifery units, but clear conclusions regarding perinatal outcome have been lacking.

The largest randomized trial of a comprehensive early intervention program for low - birth - weight, premature infants (birth to age three), the Infant Health and Development Program, included a home visiting component along with an educational centre - based program.7 At age three, intervention group children had significantly better cognitive and behavioural outcomes and improved parent - child interactions.

«Excellent outcomes with much lower intervention rates are achieved at home births.

It is the largest study of it's kind and found that low - risk women planning to give birth at home had as good outcomes as low - risk women birthing in the hospital.

According to a study in the British Medical Journal, birth outcomes in hospitals and at home are similar, except that hospital births tended to have more medical intervention — namely, caesarean sections.

So a team of Dutch researchers decided to test whether low risk women at the onset of labour with planned home birth have a higher rate of rare but severe outcomes (known as severe acute maternal morbidity or SAMM) than those with planned hospital births.

Jane Sandall was and is principal investigator for two studies evaluating models of midwife - led continuity of care (Sandall 2001), and co-investigator on the «Birthplace in England Research Programme», an integrated programme of research designed to compare outcomes of births for women planned at home, in different types of midwifery units, and in hospital units with obstetric services.

I sincerely hope you didn't give birth to your 34 week preemie at home, but I have to point out: all of those outcomes are excellent.

But you know what to do when patients have a bad outcome — throw the blame back at them by saying that they must not have taken «100 % responsibility towards having a safe and uncomplicated home birth».

And this inflammatory use of a «relative percentage risk» rather than relative risk or absolute risk... for example, even if assuming the writer's awkward data is valid, you can to look at infant living rates and see 99.6 % vs 98.4 %, which means there's only a 1.2 % higher risk of bad outcome from at - home birth than hospital.

Even your beloved Dutch midwives attending low - risk births at home have worse outcomes that Dutch obstetricians attending high - risk births in the hospital.

The MANA Stats data reflects not only the outcomes of mothers and babies who birthed at home, but also includes those who transferred to the hospital during a planned home birth, resolving a common concern about home birth data.

As a result, this study provides a much - needed look at the outcomes of women who intended to give birth at home (regardless of whether they ultimately transferred to hospital care).

Despite the care taken in this study to match the 3 groups, there may be differences regarding the women who chose home birth that placed them at either lower or higher risk for adverse outcomes that we are unable to measure.

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.

Women who give birth at home have fewer interventions, but their babies have more complications: Selected perinatal outcomes associated with planned home births in the United States

Home birth families are generally quite aware that hospitals are full of germs, sick people, and put them at risk for poor outcomes simply because they -LSB-...]

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.