ArticleBJOG : an international journal of obstetrics and gynaecology2015
Perinatal and maternal outcomes in planned home and obstetric unit births in women at 'higher risk' of complications: secondary analysis of the Birthplace national prospective cohort study.
Article in BJOG : an international journal of obstetrics and gynaecology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 36 citations in OpenAlex.
- Facilitators and Barriers to Access to Midwife-Led Birth Settings for Racialized Women in the UK: A Scoping Review.Birth (Berkeley, Calif.) · 2025Article
- Facilitating home birth in perinatal palliative care: A case report.Palliative medicine · 2024Article
- Observational
- Alternate Birth Strategies.International journal of women's health · 2023Review
- Planned Home Birth in Low-Risk Pregnancies in Spain: A Descriptive Study.International journal of environmental research and public health · 2021Article
- Client Experience with the Ontario Birth Center Demonstration Project.Journal of midwifery & women's health · 2021Article
- Is birth out-of-hospital associated with mortality and morbidity by seven years of age?PloS one · 2021Article
- Involving service users in the Birth Timing project, a data linkage study analysing the timing of births and their outcomes.International journal of population data science · 2020Article
- Evaluation of decision to delivery time interval and its effect on feto-maternal outcomes and associated factors in category-1 emergency caesarean section deliveries: prospective cohort study.BMC pregnancy and childbirth · 2020Observational
- Article
- Outcomes for the First Year of Ontario's Birth Center Demonstration Project.Journal of midwifery & women's health · 2018Article
- Planned private homebirth in Victoria 2000-2015: a retrospective cohort study of Victorian perinatal data.BMC pregnancy and childbirth · 2018Article
- The Integration of Ontario Birth Centers into Existing Maternal-Newborn Services: Health Care Provider Experiences.Journal of midwifery & women's health · 2018Article
- Prediction of uncomplicated pregnancies in obese women: a prospective multicentre study.BMC medicine · 2017Article
- Evaluating the content and quality of intrapartum care in vaginal births: An example of a state hospital.Turkish journal of obstetrics and gynecology · 2017Article
- Maternal and perinatal outcomes in women planning vaginal birth after caesarean (VBAC) at home in England: secondary analysis of the Birthplace national prospective cohort study.BJOG : an international journal of obstetrics and gynaecology · 2016Article
Corrections and comments
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Authors and funding
15 authors at 7 institutions in 1 country.
Funding
Abstract
objectiveTo explore and compare perinatal and maternal outcomes in women at 'higher risk' of complications planning home versus obstetric unit (OU) birth.
designProspective cohort study.
settingOUs and planned home births in England. POPULATION: 8180 'higher risk' women in the Birthplace cohort.
methodsWe used Poisson regression to calculate relative risks adjusted for maternal characteristics. Sensitivity analyses explored possible effects of differences in risk between groups and alternative outcome measures.
main outcome measuresComposite perinatal outcome measure encompassing 'intrapartum related mortality and morbidity' (intrapartum stillbirth, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus or clavicle) and neonatal admission within 48 hours for more than 48 hours. Two composite maternal outcome measures capturing intrapartum interventions/adverse maternal outcomes and straightforward birth.
resultsThe risk of 'intrapartum related mortality and morbidity' or neonatal admission for more than 48 hours was lower in planned home births than planned OU births [adjusted relative risks (RR) 0.50, 95% CI 0.31-0.81]. Adjustment for clinical risk factors did not materially affect this finding. The direction of effect was reversed for the more restricted outcome measure 'intrapartum related mortality and morbidity' (RR adjusted for parity 1.92, 95% CI 0.97-3.80). Maternal interventions were lower in planned home births.
conclusionsThe babies of 'higher risk' women who plan birth in an OU appear more likely to be admitted to neonatal care than those whose mothers plan birth at home, but it is unclear if this reflects a real difference in morbidity. Rates of intrapartum related morbidity and mortality did not differ statistically significantly between settings at the 5% level but a larger study would be required to rule out a clinically important difference between the groups.
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