Printer Friendly

Planned home birth in low-risk women in the Netherlands.

In the Netherlands, at least, a planned home birth has no more risk of adverse outcomes than a planned hospital birth. Ank de Jonge and colleagues used a cohort study to test the hypothesis that low-risk women with a planned home birth have a higher rate of severe, acute maternal morbidity than women with a planned hospital birth. They drew their data from 146 752 women in primary care at the onset of labour.

Their main outcome measures were severe, acute maternal morbidity (admission to an intensive care unit, eclampsia, blood transfusion of four or more units of packed cells, and other serious events), postpartum haemorrhage, and manual removal of the placenta.

Overall, 92 333 (62.9%) women had a planned home birth and 54 419 (37.1%) a planned hospital birth. The rate of severe, acute maternal morbidity among planned primary care births was 2.0 per 1 000 births. For nulliparous women the rate for a planned home versus a planned hospital birth was 2.3 versus 3.1 per 1 000 births, the rate of postpartum haemorrhage was 43.1 versus 43.3 and the rate of manual removal of the placenta was 29.0 versus 29.8.

[ILLUSTRATION OMITTED]

For parous women the rate of severe, acute maternal morbidity for a planned home versus a planned hospital birth was 1.0 versus 2.3 per 1 000 births, the rate of postpartum haemorrhage was 19.6 versus 37.6, and the rate of manual removal of the placenta was 8.5 versus 19.6.

Low-risk women in primary care at the onset of labour with a planned home birth had lower rates of severe, acute maternal morbidity, postpartum haemorrhage, and manual removal of the placenta than those with a planned hospital birth. For parous women these differences were statistically significant. Absolute risks were small in both groups. There was no evidence that a planned home birth among low-risk women leads to an increased risk of severe, adverse maternal outcomes in a maternity care system with well-trained midwives and a good referral and transportation system.

De Jonge A, et al. BMJ 2013;346:f3263. [http://dx.doi.org/10.1136/bmj.f3263] (Published 13 June 2013.)
COPYRIGHT 2013 South African Medical Association
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2013 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:Abstracts
Publication:CME: Your SA Journal of CPD
Date:Jul 1, 2013
Words:369
Previous Article:Inhaled adrenaline no better than inhaled saline for babies with bronchiolitis.
Next Article:Co-prescription of statins and antibiotics linked to extra deaths.
Topics:

Terms of use | Copyright © 2017 Farlex, Inc. | Feedback | For webmasters