Characteristics Associated With Intending and Achieving a Planned Home Birth in the United Kingdom: An Observational Study of 515,777 Maternities in the North West Thames Region, 1988–2000

Nove, Andrea; Berrington, Ann; Matthews, Zoë

doi:10.1891/2156-5287.1.2.100

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…Of these 28% in the caseload group, only 2% gave birth at home. This statistic concurs with other studies findings which showed women planning to give birth at home were more likely to be older, white, have a fluent understanding of English, and live in a more socioeconomically advantaged area (Nove et al, 2011, ONS, 2013. Another recent study (Overgaard et al, 2012) found the effect of birth place did not differ with levels of social disadvantage, these findings suggest the benefits of birth outside obstetric units applies to women of all social demographics, but are not equally accessed.…”

Section: Birth Outcomes;supporting

confidence: 91%

An investigation of the relationship between the caseload model of midwifery for socially disadvantaged women and childbirth outcomes using routine data – A retrospective, observational study

2015

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Section: Birth Outcomes;supporting

confidence: 91%

An investigation of the relationship between the caseload model of midwifery for socially disadvantaged women and childbirth outcomes using routine data – A retrospective, observational study

2015

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“…Women from the NZ cohort who planned to birth at home were more likely to be multiparous, older and with a lower BMI when compared to those women planning to birth in other settings. This replicates findings from the BPE cohort and several other observational studies (Birthplace in England Collaborative Group, 2011; Hildingsson, Lindgren, Haglund, & Radestad, 2006;MacDorman, Declercq, & Matthews, 2011;Nove, Berrington, & Matthews, 2011). In these developed countries (Sweden, America, UK), it would appear that women who plan to give birth at home are more likely to be multiparous, with a maternal age between 30 and 35 years of age, a high level of education, married or with a partner, and Caucasian or white.…”

Section: Discussionsupporting

confidence: 83%

Place of birth and outcomes for a cohort of low risk women in New Zealand: A comparison with Birthplace England

Dixon¹,

Prileszky²,

Guilliland³

et al. 2014

nzcomjnl

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rates of transfer from home (16.9%) or primary unit (12.6%) to hospital were lower than the Birthplace England cohort (21%). There was a higher proportion of nulliparous women (35%) in the planned homebirth group who transferred although this was significantly lower than the Birthplace England cohort (45%) (P<0.002). NZ Māori are the indigenous ethnicity of New Zealand, and a greater proportion of Māori planned birth in a primary unit (27.2%) than a secondary unit (23.2%), home (17.4%) or tertiary hospital (11.1%). The actual number of perinatal mortality outcomes was low across all settings for low risk women in New Zealand and differences in birthplace were not statistically significant (p < 0.14). Conclusion: A greater proportion of indigenous New Zealand women planned to birth at home or in a primary unit. Fewer women were transferred in labour in the NZ study. This research further refines our understanding of who plans to birth where, and reinforces the evidence that, where a low risk woman plans to birth in NZ, does not significantly increase adverse outcomes for her baby.

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“…The incidence of PPH for planned hospital births would be expected to be higher than the incidence for planned home births, because nulliparous women are more likely to experience PPH (see Table 2), and are also more likely to plan a hospital birth [28]. It was therefore not surprising to find that odds ratio was 2.7 before any adjustment was made for confounding.…”

Section: Discussionmentioning

confidence: 99%

Comparing the odds of postpartum haemorrhage in planned home birth against planned hospital birth: results of an observational study of over 500,000 maternities in the UK

Nove

Berrington

Matthews

2012

BMC Pregnancy Childbirth

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BackgroundThe 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. It is an observational study involving secondary analysis of maternity records, using binary logistic regression modelling. The data relate to pregnancies that received maternity care from one of fifteen hospitals in the former North West Thames Regional Health Authority Area in England, and which resulted in a live or stillbirth in the years 1988–2000 inclusive, excluding ‘high-risk’ pregnancies, unplanned home births, pre-term births, elective Caesareans and medical inductions.ResultsEven after adjustment for known confounders such as parity, the odds of postpartum haemorrhage (≥1000ml of blood lost) are significantly higher if a hospital birth is intended than if a home birth is intended (odds ratio 2.5, 95% confidence interval 1.7 to 3.8). The ‘home birth’ group included women who were transferred to hospital during labour or shortly after birth.ConclusionsWomen and their partners should be advised that the risk of PPH is higher among births planned to take place in hospital compared to births planned to take place at home, but that further research is needed to understand (a) whether the same pattern applies to the more life-threatening categories of PPH, and (b) why hospital birth is associated with increased odds of PPH. If it is due to the way in which labour is managed in hospital, changes should be made to practices which compromise the safety of labouring women.

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Characteristics Associated With Intending and Achieving a Planned Home Birth in the United Kingdom: An Observational Study of 515,777 Maternities in the North West Thames Region, 1988–2000

Abstract: Background & objectives : This study aims to identify factors which have an independent

Cited by 6 publications

References 16 publications

An investigation of the relationship between the caseload model of midwifery for socially disadvantaged women and childbirth outcomes using routine data – A retrospective, observational study

An investigation of the relationship between the caseload model of midwifery for socially disadvantaged women and childbirth outcomes using routine data – A retrospective, observational study

Place of birth and outcomes for a cohort of low risk women in New Zealand: A comparison with Birthplace England

Comparing the odds of postpartum haemorrhage in planned home birth against planned hospital birth: results of an observational study of over 500,000 maternities in the UK

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