Sentences with phrase «for women planning home birth»

This combined care, also called «shared care», is an option for women availing of public, semi-private or private care, and for women planning a home birth.

Not exact matches

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.

A major study published in the UK (Birthplace in England Collaborative Group, 2011) has examined the risks of planned home births, comparing them against planned deliveries in hospitals and midwife units for low risk women.

We should also track women who plan a home birth but wind up going to the hospital for preterm labor or other emergency, or get «risked out» of home birth before the time comes.

I really do not care if a woman wants to squat out a baby in the comfort of her home — I care that she is doing so as an act of informed free will and that she has been apprised of the risks of doing so (including the risks of 3 times or more the mortality rate for her baby compared to hospital birth and the risks of planned vaginal delivery in general).

«NCT's own detailed review of home birth concluded that, although the quality of comparative evidence on the safety of home birth is poor, there is no evidence that for women with a low risk of complications the likelihood of a baby dying is any higher if they plan for a home birth compared with planning for a hospital birth.»

For nulliparous women, planned home births also have fewer interventions but have poorer perinatal outcomes.

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 uFor 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 ufor 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 uniFor 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 unifor 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 unifor 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.&rWomen with planned home birth had lower rates of all adverse maternal outcomes, albeit not significantly so for nulliparous women.&rwomen.»

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

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).

For nulliparous women the rate for planned home versus planned hospital birth was 2.3 versus 3.1 per 1000 births (adjusted odds ratio 0.77, 95 % confidence interval 0.56 to 1.06), relative risk reduction 25.7 % (95 % confidence interval − 0.1 % to 53.5 %), the rate of postpartum haemorrhage was 43.1 versus 43.3 (0.92, 0.85 to 1.00 and 0.5 %, − 6.8 % to 7.9 %), and the rate of manual removal of placenta was 29.0 versus 29.8 (0.91, 0.83 to 1.00 and 2.8 %, − 6.1 % to 11.8 For nulliparous women the rate for planned home versus planned hospital birth was 2.3 versus 3.1 per 1000 births (adjusted odds ratio 0.77, 95 % confidence interval 0.56 to 1.06), relative risk reduction 25.7 % (95 % confidence interval − 0.1 % to 53.5 %), the rate of postpartum haemorrhage was 43.1 versus 43.3 (0.92, 0.85 to 1.00 and 0.5 %, − 6.8 % to 7.9 %), and the rate of manual removal of placenta was 29.0 versus 29.8 (0.91, 0.83 to 1.00 and 2.8 %, − 6.1 % to 11.8 for planned home versus planned hospital birth was 2.3 versus 3.1 per 1000 births (adjusted odds ratio 0.77, 95 % confidence interval 0.56 to 1.06), relative risk reduction 25.7 % (95 % confidence interval − 0.1 % to 53.5 %), the rate of postpartum haemorrhage was 43.1 versus 43.3 (0.92, 0.85 to 1.00 and 0.5 %, − 6.8 % to 7.9 %), and the rate of manual removal of placenta was 29.0 versus 29.8 (0.91, 0.83 to 1.00 and 2.8 %, − 6.1 % to 11.8 %).

For parous women the rate of severe acute maternal morbidity for planned home versus planned hospital birth was 1.0 versus 2.3 per 1000 births (0.43, 0.29 to 0.63 and 58.3 %, 33.2 % to 87.5 %), the rate of postpartum haemorrhage was 19.6 versus 37.6 (0.50, 0.46 to 0.55 and 47.9 %, 41.2 % to 54.7 %), and the rate of manual removal of placenta was 8.5 versus 19.6 (0.41, 0.36 to 0.47 and 56.9 %, 47.9 % to 66.3 For parous women the rate of severe acute maternal morbidity for planned home versus planned hospital birth was 1.0 versus 2.3 per 1000 births (0.43, 0.29 to 0.63 and 58.3 %, 33.2 % to 87.5 %), the rate of postpartum haemorrhage was 19.6 versus 37.6 (0.50, 0.46 to 0.55 and 47.9 %, 41.2 % to 54.7 %), and the rate of manual removal of placenta was 8.5 versus 19.6 (0.41, 0.36 to 0.47 and 56.9 %, 47.9 % to 66.3 for planned home versus planned hospital birth was 1.0 versus 2.3 per 1000 births (0.43, 0.29 to 0.63 and 58.3 %, 33.2 % to 87.5 %), the rate of postpartum haemorrhage was 19.6 versus 37.6 (0.50, 0.46 to 0.55 and 47.9 %, 41.2 % to 54.7 %), and the rate of manual removal of placenta was 8.5 versus 19.6 (0.41, 0.36 to 0.47 and 56.9 %, 47.9 % to 66.3 %).

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 proportion of women with a «normal birth» (birth without induction of labour, epidural or spinal analgesia, general anaesthesia, forceps or ventouse delivery, caesarean section, or episiotomy9 10) varied from 58 % for planned obstetric unit births to 76 % in alongside midwifery units, 83 % in freestanding midwifery units, and 88 % for planned home births; the adjusted odds of having a «normal birth» were significantly higher in all three non-obstetric unit settings (table 5 ⇓).

Despite a wealth of evidence supporting planned home birth as a safe option for women with low risk pregnancies, 1 — 4 the setting remains controversial in most high resource countries.

Plenty of respected research supports the safety of planned home birth (most recent large prospective trial published in the British Medical Journal), but for women who need to deliver in a hospital due to a complication, the midwife stays by your side and adopts a doula role.

Planned home births for low risk women in high resource countries where midwifery is well integrated into the healthcare system are associated with similar safety to low risk hospital births

Of women in the study who planned further children, 91 % (136/149) said they would opt for a home birth again (including four who were delivered by caesarean section).

: a Critical History Of Maternity Care by Marjorie Tew Easy Exercises For Pregnancy by Janet Balaskas Home Birth: Comprehensive Guide to Planning Childbirth at Home by Nicky Wesson Morning Sickness: a Comprehensive Guide to the Causes and Treatments by Nicky Wesson Every Woman's Birthrights by Pat Thomas Giving Birth by Sheila Kitzinger Spiritual Midwifery by Ina May Gaskin Our Babies, Ourselves: How Biology and Culture Shape the Way We Parent by Meredith Small Becoming a Grandmother by Sheila Kitzinger Not Too Late: Having a Baby After 35 by Gill Thorn Natural Baby by Janet Balaskas Child Birth Doesn't Have to Hurt by Nikki Bradford and Geoffrey Chamberlain Birth Your Way by Sheila Kitzinger The Birth Book by Carol Barbar and Jane Palmer The Complete Baby and Toddler Meal Planner by Annabel Karmel Breastfeeding by Sheila Kitzinger

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.

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).

I know some women who turned to home birth bc of a history of trauma, and others who have or plan for unassisted childbirth.

Benefits and harms of planned hospital birth compared with planned home birth for low ‐ risk pregnant women.

Authors» conclusions: There is no strong evidence from randomised trials to favour either planned hospital birth or planned home birth for low ‐ risk pregnant women.

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.

Meaning, for every 10,000 births of low risk women, there are 6 - 7 babies that die in the USA during planned, midwife - attended home births that would have lived if the mothers were giving birth at home in the Netherlands.

In a previous study where we explored women's preferences for aspects of intrapartum care regarding planned place of birth we reported that women with a preference for a hospital birth — both midwife - led and obstetrician - led — found the possibility of pain relief treatment much more important compared to women with a preference for a home birth [18].

Studies of place of birth have consistently shown lower rates of intervention in labor and birth for women with low - risk pregnancies who planned their birth at home [1 - 7].

In 2012, the home birth rate in Oregon was 2.4 %, which was the highest rate of any state; another 1.6 % of women in Oregon delivered at birth centers.11 Before licensure became mandatory in 2015, Oregon was one of two states in which licensure was not required for the practice of midwifery in out - of - hospital settings.12 Although the 2003 revision of the U.S. Standard Certificate of Live Birth distinguishes planned home births from unplanned home births, at the national level there is still no way to disaggregate hospital births that were intended to occur at a hospital and those that had not been intended to occur at a hospbirth rate in Oregon was 2.4 %, which was the highest rate of any state; another 1.6 % of women in Oregon delivered at birth centers.11 Before licensure became mandatory in 2015, Oregon was one of two states in which licensure was not required for the practice of midwifery in out - of - hospital settings.12 Although the 2003 revision of the U.S. Standard Certificate of Live Birth distinguishes planned home births from unplanned home births, at the national level there is still no way to disaggregate hospital births that were intended to occur at a hospital and those that had not been intended to occur at a hospbirth centers.11 Before licensure became mandatory in 2015, Oregon was one of two states in which licensure was not required for the practice of midwifery in out - of - hospital settings.12 Although the 2003 revision of the U.S. Standard Certificate of Live Birth distinguishes planned home births from unplanned home births, at the national level there is still no way to disaggregate hospital births that were intended to occur at a hospital and those that had not been intended to occur at a hospBirth distinguishes planned home births from unplanned home births, at the national level there is still no way to disaggregate hospital births that were intended to occur at a hospital and those that had not been intended to occur at a hospital.

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.

This study supports previous research indicating that planned home birth with qualified care providers can be a safe alternative for healthy lower risk women.

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.

Estimates of the numbers of women booked for home birth but delivering in hospital were even more difficult to obtain because hospital records do not always specify this information accurately and no national estimate exists.1 4 Data collected in this region in 1983 suggested that 35 % of these women changed to hospital based care either before or during labour, and a more detailed prospective study of all planned home births in 1993 found a total transfer rate of 43 %.8 Women were classified as having booked for a home birth when a community midwife had accepted a woman for home delivery and had this arrangement accepted by her manager and supervisor of midwives at any stage in pregnancy, irrespective of any later change of women booked for home birth but delivering in hospital were even more difficult to obtain because hospital records do not always specify this information accurately and no national estimate exists.1 4 Data collected in this region in 1983 suggested that 35 % of these women changed to hospital based care either before or during labour, and a more detailed prospective study of all planned home births in 1993 found a total transfer rate of 43 %.8 Women were classified as having booked for a home birth when a community midwife had accepted a woman for home delivery and had this arrangement accepted by her manager and supervisor of midwives at any stage in pregnancy, irrespective of any later change of women changed to hospital based care either before or during labour, and a more detailed prospective study of all planned home births in 1993 found a total transfer rate of 43 %.8 Women were classified as having booked for a home birth when a community midwife had accepted a woman for home delivery and had this arrangement accepted by her manager and supervisor of midwives at any stage in pregnancy, irrespective of any later change of Women were classified as having booked for a home birth when a community midwife had accepted a woman for home delivery and had this arrangement accepted by her manager and supervisor of midwives at any stage in pregnancy, irrespective of any later change of plan.

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

This decision uncertainty surrounding the most cost effective option was not found for place of birth in multiparous low risk women without complicating conditions, in whom planned home birth had a 100 % probability of being the most cost effective option across all thresholds of cost effectiveness (table 4).

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).

Many expecting moms assume that breast pumps are most useful for women who plan to work shortly after giving birth, but the reality of breastfeeding is that breast pumps are a helpful tool for stay - at - home moms too.

Fig 2 Cost effectiveness plane: planned birth at home compared with planned birth in obstetric units for nulliparous low risk women without complicating conditions at start of care in labour

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 ⇓).

In this study of the cost effectiveness of alternative planned places of birth in England in women at low risk of complications before the onset of labour, we found that the cost of intrapartum and after birth care, and associated related complications, was less for births planned at home, in a free standing midwifery unit, or in an alongside midwifery unit compared with planned births in an obstetric unit.

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.

Restriction of the analyses to low risk women without complicating conditions at the start of care in labour narrowed the cost differences between planned places of birth: total mean costs were # 1511 for an obstetric unit, # 1426 for an alongside midwifery unit, # 1405 for a free standing midwifery unit, and for # 1027 the home (table 2 ⇓).

This decision uncertainty surrounding the most cost effective option was not found for place of birth in multiparous low risk women, on whom planned home birth had a 100 % probability of being the most cost effective option across all cost effectiveness thresholds between # 0 and # 100000 (table 3).

Profiles of resource use, and their associated unit costs, for each planned place of birth are reported in detail in appendices 1 and 2 on bmj.com.25 The total mean costs per low risk woman planning birth in the various settings at the start of care in labour were # 1631 ($ 1950, $ 2603) for an obstetric unit, # 1461 ($ 1747, $ 2332) for an alongside midwifery unit, # 1435 ($ 1715, $ 2290) for a free standing midwifery unit, and # 1067 ($ 1274, $ 1701) for the home (table 1 ⇓).

No difference in long - term outcomes for planned home versus planned hospital births for multiparous women.