Evidence map›Paper›PMID 31864317›Full record

ArticleBMC pregnancy and childbirth2019

Mapping the trajectories for women and their babies from births planned at home, in a birth centre or in a hospital in New South Wales, Australia, between 2000 and 2012.

Vanessa L Scarf, Rosalie Viney, Serena Yu, Maralyn Foureur, Chris Rossiter, Hannah Dahlen, Charlene Thornton, Seong Leang Cheah, Caroline S E Homer

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Article in BMC pregnancy and childbirth, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Vanessa L ScarfCentre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia. Vanessa.Scarf@uts.edu.au.ORCID http://orcid.org/0000-0003-3503-9610
Rosalie VineyCentre for Health Economic Research and Evaluation (CHERE), University of Technology Sydney, PO Box 123, Broadway, Ultimo, NSW, 2007, Australia.
Serena YuCentre for Health Economic Research and Evaluation (CHERE), University of Technology Sydney, PO Box 123, Broadway, Ultimo, NSW, 2007, Australia.
Maralyn FoureurCentre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia.
Chris RossiterCentre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia.
Hannah DahlenSchool of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
Charlene ThorntonCollege of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Seong Leang CheahCentre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia.
Caroline S E HomerCentre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia.

Funding

National Health and Medical Research Council 1103015
6 · The paper itself

Abstract

backgroundIn New South Wales (NSW) Australia, women at low risk of complications can choose from three birth settings: home, birth centre and hospital. Between 2000 and 2012, around 6.4% of pregnant women planned to give birth in a birth centre (6%) or at home (0.4%) and 93.6% of women planned to birth in a hospital. A proportion of the woman in the home and birth centre groups transferred to hospital. However, their pathways or trajectories are largely unknown.

aimThe aim was to map the trajectories and interventions experienced by women and their babies from births planned at home, in a birth centre or in a hospital over a 13-year period in NSW.

methodsUsing population-based linked datasets from NSW, women at low risk of complications, with singleton pregnancies, gestation 37-41 completed weeks and spontaneous onset of labour were included. We used a decision tree framework to depict the trajectories of these women and estimate the probabilities of the following: giving birth in their planned setting; being transferred; requiring interventions and neonatal admission to higher level hospital care. The trajectories were analysed by parity.

resultsOver a 13-year period, 23% of nulliparous and 0.8% of multiparous women planning a home birth were transferred to hospital. In the birth centre group, 34% of nulliparae and 12% of multiparas were transferred to a hospital. Normal vaginal birth rates were higher in multiparous women compared to nulliparous women in all settings. Neonatal admission to SCN/NICU was highest in the planned hospital group for nulliparous women (10.1%), 7.1% for nulliparous women planning a birth centre birth and 5.1% of nulliparous women planning a homebirth. Multiparas had lower admissions to SCN/NICU for all thee settings (hospital 6.3%, BC 3.6%, home 1.6%, respectively).

conclusionsWomen who plan to give birth at home or in a birth centre have high rates of vaginal birth, even when transferred to hospital. Evidence on the trajectories of women who choose to give birth at home or in birth centres will assist the planning, costing and expansion of models of care in NSW.

Indexed as

IntentionParityAdolescentAdultBirthing CentersBirth SettingCesarean SectionDecision TreesDelivery, ObstetricExtraction, ObstetricalFemaleHome ChildbirthHumansInfant, NewbornIntensive Care Units, NeonatalNew South WalesBirth centreHome birthMidwifePlace of birthTransfer

Identifiers

PMID31864317
PMCPMC6925447

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.