Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009

Abstract

Methods:We calculated descriptive statistics for maternal demographics, antenatal risk profiles, procedures, and outcomes of planned home births in the Midwives Alliance of North American Statistics Project (MANA Stats) 2.0 data registry. Data were analyzed according to intended and actual place of birth.Results: Among 16,924 women who planned home births at the onset of labor, 89.1% gave birth at home. The majority of intrapartum transfers were for failure to progress, and only 4.5% of the total sample required oxytocin augmentation and/or epidural analgesia. The rates of spontaneous vaginal birth, assisted vaginal birth, and cesarean were 93.6%, 1.2%, and 5.2%, respectively. Of the 1054 women who attempted a vaginal birth after cesarean, 87% were successful. Low Apgar scores (Ͻ 7) occurred in 1.5% of newborns. Postpartum maternal (1.5%) and neonatal (0.9%) transfers were infrequent. The majority (86%) of newborns were exclusively breastfeeding at 6 weeks of age. Excluding lethal anomalies, the intrapartum, early neonatal, and late neonatal mortality rates were 1.30, 0.41, and 0.35 per 1000, respectively. Discussion:For this large cohort of women who planned midwife-led home births in the United States, outcomes are congruent with the best available data from population-based, observational studies that evaluated outcomes by intended place of birth and perinatal risk factors. Low-risk women in this cohort experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes.

Planned and Unplanned Home Birth

“…ABD'deki ev doğumlarının günümüzdeki en kapsamlı prospektif araştırması evde doğum yapmayı planlayan 16.924 kadını kapsıyordu (21) . Bu çalışma-da, evde doğum için tıbbi müdahale oranları düşük risk grubundaki anneler için genel olarak düşüktü.…”

A Vivência De Mulheres No Parto Domiciliar Planejado

“…Com relação à segurança do parto domiciliar, um grande estudo americano publicado em 2014, com 16.924 mulheres reforça o que outros estudos observacionais já haviam concluído anteriormente: no parto domiciliar há menores taxas de intervenções sem aumento do risco de complicações para mães e bebês, além do elevado grau de satisfação das usuárias 14 .…”

Dueling Statistics: Is Out-of-Hospital Birth Safe?

“…One of them uses Midwives Alliance of North America data to analyze outcomes in 16,924 U.S. women planning home births at labor onset (Cheyney et al, 2014). The other uses American Association of Birth Centers data to analyze outcomes in 15,574 women planning birth at freestanding birth centers at labor onset (Stapleton, Osborne, & Illuzi, 2013).…”