Homebirth Vs Birth
Independent Study
Does homebirth increase the risk of a negative maternal and fetal outcome in primigravida women than birth in a hospital setting?
Word count: 3,284
Submission date: 5th April 2013
This study intends to examine current evidence and literature on maternal and fetal outcomes in relation to birth setting. The student aims to critically analyse the findings of up to date research studies and make recommendations for change where necessary, whilst concluding whether homebirth is a safe option for primigravide women.
In Britain today all women have the right to choose where to birth their baby. For many the decision will be based on convenience, their …show more content…
The birthplace in England national prospective cohort study (British Medical Journal, 2011) was a large study in to perinatal and maternal outcomes by planned place of birth that encompassed all NHS trusts across England. A total of 64,538 women with low risk pregnancies, as defined by NICE intrapartum care guideline 2007, and included nearly 17,000 planned homebirths were recruited over a 2 year period with the study comparing results from home, midwife led unit and obstetric led unit births with researchers primarily focusing on rates of mortality and morbidity in relation to the birth setting. The study found that overall the rate of a negative maternal outcome occurring which included serious maternal complications and death was 4.3 per 1000 women and that no difference was noted between obstetric led units and non-obstetric led settings (Brocklehurst et al, 2011). Researchers then looked at their results in relation to parity alongside birth setting and found that primigravide women who had opted to birth at home had a greater incidence of neonatal complications arising when compared with primigravide women who had opted to birth in an obstetric or non-obstetric led unit. The risk of an adverse perinatal outcome was almost double for the homebirth group with 9.3 …show more content…
The most common cause for maternal transfer is haemorrhage (RCOG 2007) with any delay in transfer likely to have severe consequences for the health and wellbeing of the women. The latest CEMACE report concludes that 2 women died of direct causes following births at home out of a total of 79 maternal deaths by direct causes (CEMACE 2011). However it does not indicate the parity of the women or if the deaths occurred partly as a result of the place of delivery and so an assumption cannot be made whether homebirth was a factor in these events.
The risk of a serious maternal complication is a relatively rare occurrence regardless of birth setting and observational data obtained shows that lower intervention rates and increased maternal satisfaction with homebirth make it an increasingly popular choice for women. The small risk of maternal complications arising does not warrant the guidelines to be changed for nulliparous women who wish to birth their baby at home (RCOG
Does homebirth increase the risk of a negative maternal and fetal outcome in primigravida women than birth in a hospital setting?
Word count: 3,284
Submission date: 5th April 2013
This study intends to examine current evidence and literature on maternal and fetal outcomes in relation to birth setting. The student aims to critically analyse the findings of up to date research studies and make recommendations for change where necessary, whilst concluding whether homebirth is a safe option for primigravide women.
In Britain today all women have the right to choose where to birth their baby. For many the decision will be based on convenience, their …show more content…
The birthplace in England national prospective cohort study (British Medical Journal, 2011) was a large study in to perinatal and maternal outcomes by planned place of birth that encompassed all NHS trusts across England. A total of 64,538 women with low risk pregnancies, as defined by NICE intrapartum care guideline 2007, and included nearly 17,000 planned homebirths were recruited over a 2 year period with the study comparing results from home, midwife led unit and obstetric led unit births with researchers primarily focusing on rates of mortality and morbidity in relation to the birth setting. The study found that overall the rate of a negative maternal outcome occurring which included serious maternal complications and death was 4.3 per 1000 women and that no difference was noted between obstetric led units and non-obstetric led settings (Brocklehurst et al, 2011). Researchers then looked at their results in relation to parity alongside birth setting and found that primigravide women who had opted to birth at home had a greater incidence of neonatal complications arising when compared with primigravide women who had opted to birth in an obstetric or non-obstetric led unit. The risk of an adverse perinatal outcome was almost double for the homebirth group with 9.3 …show more content…
The most common cause for maternal transfer is haemorrhage (RCOG 2007) with any delay in transfer likely to have severe consequences for the health and wellbeing of the women. The latest CEMACE report concludes that 2 women died of direct causes following births at home out of a total of 79 maternal deaths by direct causes (CEMACE 2011). However it does not indicate the parity of the women or if the deaths occurred partly as a result of the place of delivery and so an assumption cannot be made whether homebirth was a factor in these events.
The risk of a serious maternal complication is a relatively rare occurrence regardless of birth setting and observational data obtained shows that lower intervention rates and increased maternal satisfaction with homebirth make it an increasingly popular choice for women. The small risk of maternal complications arising does not warrant the guidelines to be changed for nulliparous women who wish to birth their baby at home (RCOG