Parsons Bidewell, and Nagy (2006) studied the effect of eating in early labor on maternal and infant outcomes in a prospective comparative trial of 176 low -
risk nulliparous Australian women.
This cost effectiveness information, however, should be considered in the light of an increased risk of adverse perinatal outcome associated with planned home birth in low
risk nulliparous women.
Characteristics of low -
risk nulliparous women who initially preferred a midwife - led home or hospital birth or an obstetrician - led birth
Low -
risk nulliparous women who preferred a home birth with midwife - led care were less likely to be diagnosed with a medical indication during pregnancy compared to women who preferred a birth with obstetrician - led care (OR 0.41 95 % CI 0.25 - 0.66).
We conducted a multicenter, prospective cohort study among low -
risk nulliparous women who started their pregnancy in midwife - led care or in obstetrician - led care.
Advise low ‑
risk nulliparous women that planning to give birth 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.
Not exact matches
: «1.1.1 Explain to both multiparous and
nulliparous women who are at low
risk of complications that giving birth is generally very safe for both the woman and her 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.
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
Our results support a policy of offering healthy
nulliparous and multiparous women with low
risk pregnancies a choice of birth setting.
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, there is some evidence that planning birth at home is associated with a higher
risk of an adverse perinatal outcome.
We therefore assigned
nulliparous women the same
risk of metabolic disease as women who breastfed for 6 or more months.
We used multivariable logistic - regression models to adjust for potential confounders, including maternal race or ethnic group (non-Hispanic white vs. other), parity (
nulliparous vs. multiparous), insurance status (public or none vs. other), extent of prenatal care (≥ 5 visits vs. < 5 visits), advanced maternal age (≥ 35 years vs. < 35 years), maternal education (> 12 years vs. ≤ 12 years), history or no history of cesarean delivery, and a composite marker of conditions that confer increased medical
risk.
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.
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.
For
nulliparous low
risk women, planned birth at home generates incremental cost savings but increases adverse perinatal outcomes
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.
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
The researchers recommend that «
Nulliparous [first baby] women should be made aware of this, as well as potential
risks of expectant management during counselling.»
In fact, the absolute
risk risk of birth - related perinatal death associated with VBAC is extremely low and comparable to the
risk for
nulliparous women in labor.
These
risks may differ among different women (for instance,
nulliparous vs. multiparous), and women should understand what the
risks are so that they can make informed decisions about their personal circumstances.
Haugen, M., Brantsaeter, A. L., Trogstad, L., Alexander, J., Roth, C., Magnus, P., and Meltzer, H. M. Vitamin D supplementation and reduced
risk of preeclampsia in
nulliparous women.
Though having children and breast - feeding are known to lower a woman's
risk of certain health issues — breast cancer is one — it doesn't mean a woman with a different reproductive history is less healthy: «Our data did not suggest that
nulliparous [non-childbearing] women had poorer health as their BMI, physical activity levels, and smoking status were similar to parous women.»
The incidence of occurrence has been reported to be 9 - 15.2 % with aged,
nulliparous bitches most at
risk.