Outcomes of planned home births and planned hospital births in low-risk women in Norway between 1990 and 2007: a retrospective cohort study.

Abstract

BACKGROUND:

The safety of planned home births remains controversial in Western countries. The aim of the present study was to compare outcomes in women who planned, and were selected to, home birth at the onset of labor with women who planned for a hospital birth.

METHODS:

Data from 1631 planned home births between 1990 and 2007 were compared with a random sample of 16,310 low-risk women with planned hospital births. The primary outcomes were intrapartum intervention rates and complications. Secondary outcomes were perinatal and neonatal death rates.

RESULTS:

Primiparas who planned home births had reduced risks for assisted vaginal delivery (OR 0.32; 95% CI 0.20-0.48), epidural analgesia (OR 0.21; CI 0.14-0.33) and dystocia (OR 0.40; CI 0.27-0.59). Multiparas who planned home births had reduced risks for operative vaginal delivery (OR 0.26; CI 0.12-0.56), epidural analgesia (OR 0.08; CI 0.04-0.16), episiotomy (OR 0.48; CI 0.31-0.75), anal sphincter tears (OR 0.29; CI 0.12-0.70), dystocia (OR 0.10; CI 0.06-0.17) and postpartum hemorrhage (OR 0.27; CI 0.17-0.41). We found no differences in cesarean section rate. Perinatal mortality rate was 0.6/1000 (CI 0-3.4) and neonatal mortality rate 0.6/1000 (CI 0-3.4) in the home birth cohort. In the hospital birth cohort, the rates were 0.6/1000 (CI 0.3-1.1) and 0.9/1000 (CI 0.5-1.5) respectively.

CONCLUSIONS:

Planning for home births was associated with reduced risk of interventions and complications. The study is too small to make statistical comparisons of perinatal and neonatal mortality.

• Authors: Ellen Blix, Anette Schaumburg Huitfeldt, Pål Øian, Bjørn Straume, Merethe Kumle
• Journal: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives (Sex Reprod Healthc) Vol. 3 Issue 4 Pg. 147-53 (Dec 2012) ISSN: 1877-5764 [Electronic] Netherlands
• PMID: 23182447 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier B.V. All rights reserved.

Topics

• Adult
• Cesarean Section
• Delivery, Obstetric (mortality)
• Female
• Home Childbirth (mortality)
• Hospitals
• Humans
• Infant Mortality
• Infant, Newborn
• Labor, Obstetric
• Norway (epidemiology)
• Obstetric Labor Complications (mortality)
• Odds Ratio
• Parity
• Perinatal Mortality
• Pregnancy
• Retrospective Studies
• Risk
• Risk Factors
• Young Adult