It would not be so hard to get the rate for comparable low risk women
who planned hospital birth and run a chi - square.
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.
Women with low risk pregnancies who choose to give birth at home have a lower risk of severe complications than women
who plan a hospital birth, finds a new study.
When compared with newborns of women
who planned a hospital birth attended by a physician, those whose mothers planned a home birth were similarly at reduced risk of birth trauma (RR 0.33, 95 % CI 0.15 — 0.74), resuscitation at birth (RR 0.56, 95 % CI 0.32 — 0.96) and oxygen therapy behond 24 hours (RR 0.38, 95 % CI 0.24 — 0.61)(Table 4, Appendix 1).
Compared with women
who planned a hospital birth with a midwife or physician in attendance, those who planned a home birth were significantly less likely to experience any of the obstetric interventions we assessed, including electronic fetal monitoring, augmentation of labour, assisted vaginal delivery, cesarean delivery and episiotomy (Table 3).
A quarter of women
who planned hospital births had C - sections that can add serious complications to future pregnancies — five times the rate of C - section among those who planned to give birth outside the hospital.
Compared with women
who planned a hospital birth with a midwife in attendance, those who planned a home birth were significantly less likely to have a third - or fourth - degree perineal tear (adjusted relative risk [RR] 0.43, 95 % CI 0.29 — 0.63), postpartum hemorrhage (RR 0.62, 95 % CI 0.49 — 0.77) or pyrexia (RR 0.45, 95 % CI 0.29 — 0.76)(Table 3).
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.
Not exact matches
As a result, for women
who are concerned about the costs related to giving
birth, it's important to explore the average costs at their local
hospitals and review their insurance
plans before they decide to become pregnant.
I had a doula, I had a
birth plan that my OB and I went over together and she signed off on (and then faxed a copy to the nurse manager at the
hospital so they were aware), and I had a nurse
who was happy to accommodate my wishes.
She also has a great understanding of women
who planned to
birth at home and were transferred to the
hospital, as well as attachment parenting issues.
A private effort, the Idaho Perinatal Project run by St. Luke's, documented 138 instances between 2005 and 2011 where mothers
who planned a home
birth were transported to a
hospital.
«While most pregnant women
who choose to have
planned home
births are at lower risk of complications due to careful screening,
planned home
births are associated with double to triple the risk of infant death than are
planned hospital births.
We might also find a number of babies
who had lethal congenital anomalies,
who would not have survived no matter where they were born or
who attended the
birth; there may be important differences between home and
hospital populations with regard to whether these anomalies were detected prenatally and whether parents changed their
birth plans because of it.
I had a client
who was
planning a home
birth but it turned course leading to a transfer to the
hospital and a cesarean
birth, two opposite ends of the birthing spectrum.
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.
At the first Summit, delegates agreed that healthy women with healthy pregnancies
who desire a
planned home
birth should be able to access a maternity care professional within an organized system that provides transfer to
hospital - based services when needed.
Knowing I was a doula
who had
planned on a home
birth, they were respectful and thoughtful with the decisions I was making and left me and my husband to labor on our own (as much as a
hospital can allow).
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.
I found that 87 % of women
who planned nonhospital
birth agreed with the statement, «Generally speaking, giving
birth in a non-
hospital setting is at least as safe as giving
birth in a
hospital for low - risk women» (69 % strongly agreed).
It also helps to talk to other women
who gave
birth with your doctor, ask about their C - section rates, and take a
hospital tour with your
birth plan in hand.
Those women
who had a relatively difficult previous
birth may have been more likely to
plan a
hospital birth next time, even if there was no official medical indication.
«What gave me the heads up on
hospital interference was Dr. Marsden Wagner (formerly of
WHO) who wrote a great book:» Creating Your Birth Pl
WHO)
who wrote a great book:» Creating Your Birth Pl
who wrote a great book:» Creating Your
Birth Plan.
This class is great for couples
who are
planning a
hospital specific
birth and want more information on interventions, comfort techniques, and plenty of tips and fun.
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.
The low emergency caesarean section rate and assisted vaginal
birth rate in our study were consistent with the low rate of caesarean section (2.8 %) recorded in the Birthplace in England Study for women
who planned a homebirth, 43 and in a South Australian study (9.2 % for
planned homebirths v 27.1 % for
hospital births).13 A low rate of caesarean section is also consistent with studies of homebirth in the US.36
Many
hospitals today offer birthing centers, a place within the
hospital that is set apart specifically to serve women
who have developed a
birth plan for natural
birth.
But as I learned more through my pregnancy, I became more aware of my options, and although I did give
birth in the
hospital setting, I was blessed with great staff, a great doula, and an assigned nurse
who was in fact completing her midwifery courses, so my
birth plan was well respected, and I'm proud to say I didn't need any medication!
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.
She had a cord accident and as it happened out of
hospital (precip
birth, not
planned HB) her not breathing was totally unexpected —
who expects that?
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).
One of my favorite doulas in south Florida, Lisa Raynor (right)
who works with expecting moms
planning hospitals births in Broward and Palm Beach county, she is well known by nurses, OBGYNS and midwives in Boca Raton Regional
Hospital, Northwest Medical Center, Broward Health Medical Center, and far far more.
The lone voices of reason are myself, a woman
who is an anesthesiologist and another woman whose husband is a pediatrician and 1 - 2 others
who are
planning hospital births.
After the reclassification of transferred patients, the out - of -
hospital rate of cesarean delivery (performed by a physician
who was not the
planned birth attendant) was 5.3 %.
Obstetrical procedures were more common among women
who had
planned in -
hospital births than among women
who delivered out of the
hospital (30.4 % vs. 1.5 % for induction of labor and 26.4 % vs. 1.1 % for augmentation of labor, P < 0.001 for both comparisons)(Table 3).
The proportions of women
who were white, had private insurance or paid out of pocket, or were of advanced maternal age were higher among women
who planned out - of -
hospital birth than among those
who planned in -
hospital birth (Table 1).
Planned hospital births included all births that occurred in the hospital with the exception of births that occurred after intrapartum transfer to the hospital of a woman who had planned an out - of - hospital de
Planned hospital births included all
births that occurred in the
hospital with the exception of
births that occurred after intrapartum transfer to the
hospital of a woman
who had
planned an out - of - hospital de
planned an out - of -
hospital delivery.
Whereas all women
who had
planned a home
birth registered that event as a home delivery, 14 % of women
who had booked a
hospital birth but delivered at home, or before admission, in 1993 registered the
birth as occurring in the
hospital to which they were admitted after delivery.
Home
birth is uncommon in the United Kingdom and uncertainty exists about its safety.1 2 Almost all mortality figures available nationally1 provide merely a single global figure for
planned and unplanned home
births, though the constituent rates differ greatly.3 The only recent figures for
planned home
birth in England and Wales relating to 19794 and 19935 provide an inaccurately low estimate of risk because it was not possible to account for those mothers
who originally booked to have a home delivery but ended up delivering in
hospital.
In the study of nearly 150,000 low - risk women in the Netherlands
who gave
birth between 2004 and 2006, 92,333 had a
planned home
birth and 54,419 had a
planned hospital birth.
Many modern women
who plan an unassisted
birth choose an available
hospital as a backup
plan.
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.
It is also important for women thinking about a
planned home
birth to consider if they are healthy and considered low - risk and to work with a CNM, certified midwife, or physician
who practices in an integrated and regulated health system; have ready access to consultation; and have a
plan for safe and quick transportation to a nearby
hospital in the event of an emergency.
Inclusion criteria were as follows: the study population was women
who chose
planned home
birth at the onset of labor; the studies were from Western countries; the
birth attendant was an authorized mid-wife or medical doctor; the studies were published in 1985 or later, with data not older than from 1980; and data on transfer from home to
hospital were described.
Midwifery advocates often cite what they see as the biggest irony of anti-midwife laws like the one in Missouri: that a good Samaritan
who helps a woman deliver her baby on the side of a road or in a taxi cab is not subject to prosecution, but that a trained midwife
who helps a woman carefully
plan her out - of -
hospital birth is.
We have NICU nurses
who are saying things along the lines of, «Well, if moms were less strict about their
birth plan, if they compromised a little bit more, if they didn't have to have everything their way, then we'd probably have healthier
births in the
hospital.»
The couple,
who are
planning a
hospital birth with a nurse - midwife for their baby due this summer, have lobbied Illinois legislators to change the law.
Pregnant women and their partners
who are considering where to give
birth should be informed that they may be at higher risk of PPH if they
plan a
hospital birth than if they
plan a home
birth.
In the study group, about 75 % of the women
who planned to give
birth at home were able to, and about 97 % of those
who planned to give
birth in
hospital had their babies there.
This study aimed to compare the risk of PPH between those
who intended a home
birth at the end of pregnancy (whether or not they went on to experience a home
birth) and those
who had a
planned hospital birth.