An impact analysis to measure what difference home visiting programs make in maternal prenatal health, health care use, preterm births and
other birth outcomes, and infant health and health care use.
Studies suggest an association between prenatal anemia and risk of premature (preterm) birth, but evidence on
other birth outcomes is inconsistent.
Not exact matches
Without knowing
other specifics of the
birth, it would be unjust and presumptious to say or imply that a trained midwife or a hospital
birth would have made any difference to the
outcome.
On the
other hand, even a small percentage of misclassified
outcomes in the home
birth category have a dramatic impact.
The hospital
birth was «good, but not great» and the
other couple feel that a good
outcome at hospital the first time around guarantees that the mother and baby will be fine second time around, so they now have an attitude of «why bother» going to the hospital.
Helping adolescent males to delay fatherhood may also be important from a child health perspective: research that controlled for maternal age and
other key factors found teenage fatherhood associated with an increased risk of adverse pregnancy
outcomes, including preterm
birth, low
birth weight and neonatal death (Chen et al, 2007).
Dr. Fisher believes that dispassionate, rigorous study of
birth across all settings is more important than ever given disparities in women's access to trained and licensed care providers, current and future physician workforce issues, rising costs of health care, and unacceptably high rates of adverse
outcomes for mothers and infants in the U.S. compared to
other industrialized countries.
The workshop featured presentations from invited speakers and discussions to highlight research findings that advance our understanding of the effects of maternal care services in different types of institutional settings on maternal labor, clinical and
other birth procedures, and
birth outcomes.
Unplanned home
births are likely emergencies involving precipitous labor or
other complications that might result in poorer - than - average
outcomes when occurring in a setting unprepared for this type of delivery.
N: It can be challenging to help
others grasp a bigger picture of adoption
outcomes; children who are adopted may have different perspectives and feelings than their
birth and / or adoptive families.
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
Parents experiencing unplanned - for surgical
birth (nearly 30 % of Ventura County mothers have surgical
births, many unplanned), or
other unexpected
outcomes encounter more challenges, which can be addressed with persistence and professional and peer support till babe is thriving on mamas breast.
There were no significant differences in
outcome of home or hospital
births attended by midwives for the
other child health measures.
«The CDC report and
other research shows that babies born to women cared for by Certified Professional Midwives are far less likely to be preterm or low
birth weight, two of the primary contributing factors not only to infant mortality, but to racial and ethnic disparities in
birth outcomes.»
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.
Don't forget about the 2005 study that compared
outcomes of CPM attended
births and hospital
births, where the results showed similar IP and neonatal death rates for both, but CPM attended
births fared better in
other categories.
The goal of the
Birth by the Numbers website is to present accurate, up - to - date information on childbirth practices and
outcomes in the United States and
other countries.
Studies have shown that trying to use ultrasounds or
other imaging to guesstimate whether the baby (or babies) will fit through mom's pelvis doesn't help the
birth outcome.
We restricted the denominator to live
births for all
other outcomes, since only live - born neonates were at risk for those
outcomes (e.g., neonatal death).
For example, the fact that 27 transfer patients are listed as having a physician as their planned
birth attendant is most likely due to errors in
birth - certificate completion; data are currently lacking to inform the degree of misclassification related to this and
others factors that affect the study
outcomes.
Our hypothesis was that women with an elevated fear of
birth would emerge as a distinct profile that had poorer pregnancy and
birth outcomes than
other women.
For all low risk women, bootstrapped estimates showed that planned
birth in settings
other than an obstetric unit was associated with cost savings and considerable stochastic uncertainty surrounding adverse perinatal
outcomes.
The authors suggest that autonomy in the context of choosing place of
birth is defined by three main attributes: information, capacity and freedom; given the antecedent of not harming
others, and the consequences of accountability for the
outcome.
The paucity of evidence for the longer term consequences of adverse events and
other health
outcomes after
birth for both mother and baby remains and further research to generate combined QALY estimates for the linked mother - baby dyad should be a priority for research in this specialty.
A new article published in Clinical Lactation addresses potential negative
outcomes of epidurals and
other birth interventions.
A woman choosing place of
birth is autonomous if she receives all relevant information on available choices, risks and benefits, is capable of understanding and processing the information and choosing place of
birth in the absence of coercion, provided she intends no harm to
others and is accountable for the
outcome.
For the purposes of this economic evaluation, the forms were initially used in a related study funded by the National Institute of Health Research (NIHR) research for patient benefit programme «assessing the impact of a new
birth centre on choice and
outcome of maternity care in an inner city area,» which will be reported in full elsewhere, comparing the costs of care in a free standing midwifery unit with care in an obstetric unit in the same trust.16 The data collected included details of staffing levels, treatments, surgeries, diagnostic imaging tests, scans, drugs, and
other resource inputs associated with each stage of the pathway through intrapartum and after
birth care.
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.
Adverse neonatal
outcomes including death were determined by place of
birth and attendant type for in - hospital CNM, in - hospital «
other» midwife, home certified nurse midwife, home «
other» midwife, and free - standing
birth center CNM deliveries.
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.
Assumed differences between caseload or team models of care versus
other models of care could not explain the heterogeneity for these
outcomes, and neither could potential differences between low - risk and mixed - risk groups of pregnant women (See analyses for regional analgesia Analysis 2.1 and Analysis 3.1 and for preterm
birth Analysis 2.6 and Analysis 3.6).
The SMMIS database is extremely useful for the study of pregnancy
outcomes by place of
birth, because it overcomes many of the problems inherent within
other data sources.
This is understandable; if planned home
birth is associated with a greatly elevated risk of serious negative infant
outcomes, then most women and clinicians would be reluctant to attach as much importance to
other benefits it might offer.
Measures ofmaternal satisfaction were reported in one study of 15 women, but there were insufficient data to draw any conclusions; no
other secondary
outcomes were reported for women with multiple
births in either study.
lion of zion, for the specific population of healthy normal woman with healthy normal pregnancies, they have found that home
births actually have better
outcomes for both baby and mother — i.e. better apgars, better weight gain after the
birth, and
other indicators of maternal and baby wellbeing.
By facilitating their involvement in parenting programs, these families will have the opportunity to change some of their parenting behaviours and beliefs, which may ultimately buffer children who are at risk of poor developmental
outcomes because of genetic vulnerability, low
birth weight, low socio - economic status, or cumulative environmental risks, among
others.
Dr Tuteur's point was that women of African descent are at higher risk of obstetric problems compared to
other ethnic groups, that 1 in 6 women giving
birth in the US is of African descent, and that this may explain disparity of
outcome to some extent.
Those who have actually read the Cheyney study can see that the authors compared their
outcomes to many
other studies on planned home
birth and found no differences in intrapartum and neonatal death rates.
If you were truly interested in
outcomes that may be attributed to place of
birth, then you would want to compare cohorts that are as similar as possible in
other ways.
We readily gather statistics and share our
birth outcomes with
other birth professionals and to help establish home
birth midwifery in our western culture.
Regardless of
outcomes, interventions used, or paths taken, will a woman who feels in control of her
birth choices go on to take more control of
other areas of her life than a women who choices a passive role?
This may be different in
other countries, but it is not unexpected in the Netherlands, where home
birth has been an approved option for a long time.1 5 12 After background variables were controlled for, the perinatal
outcome for primiparous women with low risk pregnancies was similar for those who planned home
births and those who planned hospital
births.
In addition to birthweight,
other perinatal
outcomes examined in previous studies include the timing and quantity of prenatal care, health - care costs at and around
birth, and infant and neonatal mortality.
Comparison 2 Midwife - led versus
other models of care: variation in midwifery models of care (caseload / one - to - one or team),
Outcome 3 Instrumental vaginal
birth (forceps / vacuum).
Other investigators have reported a significant increase in adverse perinatal
outcomes related to planned home
births, especially where skilled
birth attendants are not universally integrated into regional health systems, or in population - based studies that include at - risk pregnancies [20 — 22].
Comparison 2 Midwife - led versus
other models of care: variation in midwifery models of care (caseload / one - to - one or team),
Outcome 2 Caesarean
birth.
Comparison 1 Midwife - led versus
other models of care for childbearing women and their infants (all),
Outcome 15 Attendance at
birth by known midwife.
Other professional organisations have issued statements questioning the evidence basis for support of women's choice of
birth place, and stating that hospital
birth is the only setting that assures safe
outcomes [27, 28].
Comparison 2 Midwife - led versus
other models of care: variation in midwifery models of care (caseload / one - to - one or team),
Outcome 6 Preterm
birth (< 37 weeks).
Comparison 3 Midwife - led versus
other models of care: variation in risk status (low versus mixed),
Outcome 3 Instrumental vaginal
birth (forceps / vacuum).