Selected perinatal outcomes associated with planned home births in the United States

Maternal Results From Planned Home Births Assisted by Nurses From the Hanami Team in the South of Brazil, 2002-2012

“…The majority of the findings are similar to those already published in studies undertaken in Brazil and other, developed, countries. 4,6,10,12-13, [23][24][25][26] One of the limitations for discussing the present study's findings is the meager publication of quantitative Brazilian data regarding assistance at home so as to compare the results obtained. [10][11]19 In relation to the sociodemographic characteristics, the age range of the majority of the women was below that found in the international studies (between 30 and 34 years old) [26][27][28][29][30] and in another Brazilian study (30-35 years old).…”

“…10 The high educational level is in consonance with another Brazilian study, in which 62.8% of the women assisted at home had a higher education, 10 and with one international study. 23 Women with a high educational level tend to have more access to information and knowledge, which allows them to question the currently-dominant model of health and opt for a different locale to give birth to their children, as they believe the home to be an intimate, familiar and safe place, as well as seeking professionals who are trained and qualified for this care.…”

“…[3][4]6,12,[23][24][26][27][28][29][30]32,34 However, one can observe an increase in the number of multiparous women who opted for home birth (Figure 2), which may result from the satisfaction with the previous experience of birth at home, and from the dissatisfaction of women who gave birth for the first time in hospital.…”

Planned Out-of-Hospital Birth and Birth Outcomes

“…2,5,9 A key shortcoming of prior studies of planned home birth is the classification of births by the eventual rather than the intended place of birth (i.e., intrapartum home-to-hospital transfers were counted as hospital births). 3,7,10 In 2012, the home birth rate in Oregon was 2.4%, which was the highest rate of any state; another 1.6% of women in Oregon delivered at birth centers. 11 Before licensure became mandatory in 2015, Oregon was one of two states in which licensure was not required for the practice of midwifery in out-of-hospital settings.…”

“…1 There has been a parallel trend in the use of birth centers, from 0.23% in 2004 to 0.39% in 2012. 2 According to recent U.S. studies of out-of-hospital birth, women planning to deliver at home had lower rates of obstetrical intervention, [3][4][5] and their infants had higher rates of complications and death. 3,6,7 Potential explanations for these findings as they relate to obstetrical interventions include differences in models for obstetrical care (i.e., care provided by an obstetrician, by a certified nurse-midwife, or by certified professional midwife 8 ), in the practices of the birth attendant, in provider and maternal preference for (and the availability of) medical technology, and in maternal characteristics.…”