ArticleEClinicalMedicine2020
Maternal outcomes and birth interventions among women who begin labour intending to give birth at home compared to women of low obstetrical risk who intend to give birth in hospital: A systematic review and meta-analyses.
Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 99 citations in OpenAlex.
- Midwifery Students' Definitions of Normal Labor and Birth: A Study From Five Countries.Birth (Berkeley, Calif.) · 2026Article
- The freebirth debate: Respecting autonomy while reflecting on our own practices.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Article
- The meanings attributed by obstetricians to planned home birth.Revista brasileira de enfermagem · 2025Article
- Exploring midwifery students' experiences of clinical training in planned home birth: A qualitative study.European journal of midwifery · 2025Article
- Exploring the landscape of Canadian midwifery research: strengths, gaps and priorities - results of a scoping review.BMJ open · 2024Article
- The relationship between ethnicity and place of birth in England: a mixed-methods study.BMC pregnancy and childbirth · 2024Article
- Social support network of Brazilian Amazonian women to subsidise the decision-making power of planned home birth: a qualitative study.BMJ open · 2024Article
- Cost minimisation analyses of birth care in low-risk women in Norway: a comparison between planned home birth and birth in a standard obstetric unit.BMC health services research · 2024Article
- Experienced disrespect & abuse during childbirth and associated birth characteristics: a cross-sectional survey in the Netherlands.BMC pregnancy and childbirth · 2024Article
- Health professionals' perceptions of planned home birth care within the Brazilian health system.BMC pregnancy and childbirth · 2023Article
- Planned hospital birth compared with planned home birth for pregnant women at low risk of complications.The Cochrane database of systematic reviews · 2023Review
- The natural pattern of birth timing and gestational age in the U.S. compared to England, and the Netherlands.PloS one · 2023Article
- Midwives' experiences of facilitating normal birth in midwifery-led units in Norway: A qualitative study.European journal of midwifery · 2023Article
- Cognitive impairment and the associated factors among women with a history of pregnancy complications in rural southwestern Uganda.PloS one · 2023Article
- A lack of reproductive agency in facility-based births makes home births a first choice regardless of potential risks and medical needs-a qualitative study among multiparous women in Somaliland.Global health action · 2022Article
- Article
- Characteristics of Homebirth in Hungary: A Retrospective Cohort Study.International journal of environmental research and public health · 2022Article
- Are perinatal quality collaboratives collaborating enough? How including all birth settings can drive needed improvement in the United States maternity care system.Birth (Berkeley, Calif.) · 2022Article
- A true choice of place of birth? Swiss women's access to birth hospitals and birth centers.PloS one · 2022Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe previously concluded that risk of stillbirth, neonatal mortality or morbidity is not different whether birth is intended at home or hospital. Here, we compare the occurrence of birth interventions and maternal outcomes among low-risk women who begin labour intending to birth at home compared to women intending to birth in hospital.
methodsWe used our registered protocol (PROSPERO, http://www.crd.york.ac.uk, No.CRD42013004046) and searched five databases from 1990-2018. Using R, we obtained pooled estimates of effect (accounting for study design, study setting and parity).
findings16 studies provided data from ~500,000 intended home births for the meta-analyses. There were no reported maternal deaths. When controlling for parity in well-integrated settings we found women intending to give birth at home compared to hospital were less likely to experience: caesarean section OR 0.58(0.44,0.77); operative vaginal birth OR 0.42(0.23,0.76); epidural analgesia OR 0.30(0.24,0.38); episiotomy OR 0.45(0.28,0.73); 3rd or 4th degree tear OR 0.57(0.43,0.75); oxytocin augmentation OR 0.37(0.26,0.51) and maternal infection OR 0.23(0.15,0.35). Pooled results for postpartum haemorrhage showed women intending home births were either less likely or did not differ from those intending hospital birth [OR 0.66(0.54,0.80) and RR 1.30(0.79,2.13) from 2 studies that could not be pooled with the others]. Similar results were found when data were stratified by parity and by degree of integration into health systems.
interpretationAmong low-risk women, those intending to birth at home experienced fewer birth interventions and untoward maternal outcomes. These findings along with earlier work reporting neonatal outcomes inform families, health care providers and policy makers around the safety of intended home births.
fundingPartial funding: Association of Ontario Midwives open peer reviewed grant.
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