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AUSER on 5/22/2006 7:39:12 PM |
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homebirth |
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Let's look in more detail at what actually happened to the 7286 women who registered for home births in the Johnson 2005 study:
Johnson KC, Daviss BA. Outcomes of planned home births with certified professional midwives: large prospective study in North America. BMJ 2005;330(7505):1416.
-- 103 women made an initial visit and never returned
-- 436 (6%) had social reasons (chose hospital birth, moved, changed midwife, cost, other) for not having a home birth
-- 469 were referred for medical reasons (6.5%), including pregnancy complications (205), miscarried (171), preterm labor (58), antepartum fetal death at 20 wks or more (19), twins (16)
-- Of the women continuing care with the midwife, 667 (11%) intended care in a birth center at labor onset, and 163 (2.5%) intended a hospital birth.
-- Of the 5418 women still planning a home birth at labor onset, 655 (12%) were transferred to hospital during labor or afterwards. Almost all (83%) of these transfers were before the birth, and in half of these cases, the reason was poor progress, desire for pain relief, or exhaustion. The cesarean rate among these 5418 women was less than 4%, so the vast majority of the transfers in labor resulted in vaginal births.
So you see, when you look at the details, a very different picture emerges: Less than 7% of the original population were transferred out of midwifery care in pregnancy, of which only half had pregnancy complications of some kind, and nearly 90% of women intending home birth at the onset of labor gave birth and recovered at home.
As for a bibliography of home birth studies, I append a list. In addition to these, there is the infamous Pang 2002 study, concluding that home birth was dangerous. I have deconstructed that study elsewhere on this site.
Ackermann-Liebrich U et al. Home versus hospital deliveries: follow up study of matched pairs for procedures and outcome. BMJ 1996;313(7068):1276-7.
Bastian H, Keirse MJ, and Lancaster PA. Perinatal death associated with planned home birth in Australia: population based study. BMJ 1998;317(7155):348-8.
Duran AM. The safety of home birth: the Farm study. Am J Public Health 1992;82(3):450-453.
Gulbransen G, Hilton J, McKay L, et al. Home birth in New Zealand 1973-93: incidence and mortality. N Z Med J 1997;110(1040):87-9.
Janssen PA, Lee SK, Ryan EM, et al. Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia. CMAJ 2002;166(3):315-23.
Johnson KC, Daviss BA. Outcomes of planned home births with certified professional midwives: large prospective study in North America. BMJ 2005;330(7505):1416.
Olsen O. Meta-analysis of the safety of home birth. Birth 1997;24(1):4-13.
Weigers TA et al. Outcome of planned home and planned hospital births in low risk pregnancies: prospective study in midwifery practices in The Netherlands. BMJ 1996;313(7068):1309-13.
Woodcock HC et al. A matched cohort study of planned home and hospital births in Western Australia 1981-1987. Midwifery 1994;10(3):125-35.
-- Henci By: Henci Goer |
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