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. 2018 Sep 4;18(1):357.
doi: 10.1186/s12884-018-1996-6.

Planned private homebirth in Victoria 2000-2015: a retrospective cohort study of Victorian perinatal data

Miranda L Davies-Tuck  1   2 , Euan M Wallace  3   4 , Mary-Ann Davey  4   5 , Vickie Veitch  4 , Jeremy Oats  6
Affiliations

Planned private homebirth in Victoria 2000-2015: a retrospective cohort study of Victorian perinatal data

Miranda L Davies-Tuck et al. BMC Pregnancy Childbirth. .

Abstract

Background: The outcomes for planned homebirth in Victoria are unknown. We aimed to compare the rates of outcomes for high risk and low risk women who planned to birth at home compared to those who planned to birth in hospital.

Methods: We undertook a population based cohort study of all births in Victoria, Australia 2000-2015. Women were defined as being of low or high risk of adverse pregnancy outcomes according to the eligibility criteria for homebirth and either planning to birth at home or in a hospital setting at the at the onset of labour. Rates of perinatal and maternal mortality and morbidity as well as obstetric interventions were compared.

Results: Three thousand nine hundred forty-five women planned to give birth at home with a privately practising midwife and 829,286 women planned to give birth in a hospital setting. Regardless of risk status, planned homebirth was associated with significantly lower rates of all obstetric interventions and higher rates of spontaneous vaginal birth (p ≤ 0.0001 for all). For low risk women the rates of perinatal mortality were similar (1.6 per 1000 v's 1.7 per 1000; p = 0.90) and overall composite perinatal (3.6% v's 13.4%; p ≤ 0.001) and maternal morbidities (10.7% v's 17.3%; p ≤ 0.001) were significantly lower for those planning a homebirth. Planned homebirth among high risk women was associated with significantly higher rates of perinatal mortality (9.3 per 1000 v's 3.5 per 1000; p = 0.009) but an overall significant decrease in composite perinatal (7.8% v's 16.9%; p ≤ 0.001) and maternal morbidities (16.7% v's 24.6%; p ≤ 0.001).

Conclusion: Regardless of risk status, planned homebirth was associated with significantly lower rates of obstetric interventions and combined overall maternal and perinatal morbidities. For low risk women, planned homebirth was also associated with similar risks of perinatal mortality, however for women with recognized risk factors, planned homebirth was associated with significantly higher rates of perinatal mortality.

Keywords: High risk; Home birth; Perinatal outcomes.

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Conflict of interest statement

Ethics approval and consent to participate

This study was conducted under the auspices of the CCOPMM and approved by the Monash University Human Research Ethics Committee (Project Number 0743). As routinely collected data was accessed, no written consent from women was obtained.

Consent for publication

Not Applicable.

Competing interests

MDT and JO have a secondment to CCOPMM. MAD and VV are employees of the Clinical Councils Unit which manages the VPDC data and EW is a CEO of Safer Care Victoria, Department of health. These conflicts do not alter adherence to the BMC policies.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Number of women per annum who, at the beginning of labour, planned to birth at home with a privately practising midwife
See this image and copyright information in PMC

References

    1. Birthplace in England Collaborative Group. Brocklehurst P, Hardy O, Hollowell J, Linsell L, Macfarlane A, McCourt C, Marlow N, Miller A, Newburn M, et al. perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the birthplace in England national prospective cohort study. BMJ. 2011;d7400:343. - PMC - PubMed
    1. de Jonge A, Geerts C, van der Goes B, Mol B, Buitendijk S, Nijhuis J. Perinatal mortality and morbidity up to 28 days after birth among 743 070 low-risk planned home and hospital births: a cohort study based on three merged national perinatal databases. BJOG. 2015;122(5):720–728. doi: 10.1111/1471-0528.13084. - DOI - PubMed
    1. Homer CS, Thornton C, Scarf VL, Ellwood DA, Oats JJ, Foureur MJ, Sibbritt D, McLachlan HL, Forster DA, Dahlen HG. Birthplace in New South Wales, Australia: an analysis of perinatal outcomes using routinely collected data. BMC Pregnancy Childbirth. 2014;14:206. doi: 10.1186/1471-2393-14-206. - DOI - PMC - PubMed
    1. Hutton EK, Reitsma AH, Kaufman K. Outcomes assocaited with planned home and planned hospital births in low-risk women attended by midwives in Ontario, Canada, 2003-2006: a retrospective cohort study. Birth. 2009;36(3):180–189. doi: 10.1111/j.1523-536X.2009.00322.x. - DOI - PubMed
    1. Janssen PA, Saxell L, Page LA, Klein MC, Liston RM, SK L. outcomes of planned home birth with registered midwife versus planned hospital birth with a midwife or physician. CMAJ. 2009;181:377–383. doi: 10.1503/cmaj.081869. - DOI - PMC - PubMed