Outcomes of care for 16,924 planned home births in the United States

The midwives alliance of North America statistics project, 2004 to 2009

Melissa Cheyney, Marit Bovbjerg, Courtney Everson, Wendy Gordon, Darcy Hannibal, Saraswathi Vedam

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Introduction: Between 2004 and 2010, the number of home births in the United States rose by 41%, increasing the need for accurate assessment of the safety of planned home birth. This study examines outcomes of planned home births in the United States between 2004 and 2009. Methods: We calculated descriptive statistics for maternal demographics, antenatal risk profiles, procedures, and outcomes of planned home births in the Midwives Alliance of North American Statistics Project (MANA Stats) 2.0 data registry. Data were analyzed according to intended and actual place of birth. Results: Among 16,924 women who planned home births at the onset of labor, 89.1% gave birth at home. The majority of intrapartum transfers were for failure to progress, and only 4.5% of the total sample required oxytocin augmentation and/or epidural analgesia. The rates of spontaneous vaginal birth, assisted vaginal birth, and cesarean were 93.6%, 1.2%, and 5.2%, respectively. Of the 1054 women who attempted a vaginal birth after cesarean, 87% were successful. Low Apgar scores (< 7) occurred in 1.5% of newborns. Postpartum maternal (1.5%) and neonatal (0.9%) transfers were infrequent. The majority (86%) of newborns were exclusively breastfeeding at 6 weeks of age. Excluding lethal anomalies, the intrapartum, early neonatal, and late neonatal mortality rates were 1.30, 0.41, and 0.35 per 1000, respectively. Discussion: For this large cohort of women who planned midwife-led home births in the United States, outcomes are congruent with the best available data from population-based, observational studies that evaluated outcomes by intended place of birth and perinatal risk factors. Low-risk women in this cohort experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes.

Original languageEnglish (US)
Pages (from-to)17-27
Number of pages11
JournalJournal of Midwifery and Women's Health
Volume59
Issue number1
DOIs
StatePublished - Jan 1 2014

Fingerprint

Midwifery
North America
Parturition
Vaginal Birth after Cesarean
Mothers
Newborn Infant
Labor Onset
Epidural Analgesia
Apgar Score
Needs Assessment
Birth Rate
Infant Mortality
Oxytocin
Breast Feeding
Postpartum Period
Observational Studies
Registries
Demography
Outcome Assessment (Health Care)
Safety

Keywords

  • Birth place
  • Home childbirth
  • Midwife
  • Midwifery
  • Perinatal outcome
  • Pregnancy outcomes

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Maternity and Midwifery

Cite this

Outcomes of care for 16,924 planned home births in the United States : The midwives alliance of North America statistics project, 2004 to 2009. / Cheyney, Melissa; Bovbjerg, Marit; Everson, Courtney; Gordon, Wendy; Hannibal, Darcy; Vedam, Saraswathi.

In: Journal of Midwifery and Women's Health, Vol. 59, No. 1, 01.01.2014, p. 17-27.

Research output: Contribution to journalArticle

Cheyney, Melissa ; Bovbjerg, Marit ; Everson, Courtney ; Gordon, Wendy ; Hannibal, Darcy ; Vedam, Saraswathi. / Outcomes of care for 16,924 planned home births in the United States : The midwives alliance of North America statistics project, 2004 to 2009. In: Journal of Midwifery and Women's Health. 2014 ; Vol. 59, No. 1. pp. 17-27.
@article{5ccfc6e5fc024077a95b43f79db7d843,
title = "Outcomes of care for 16,924 planned home births in the United States: The midwives alliance of North America statistics project, 2004 to 2009",
abstract = "Introduction: Between 2004 and 2010, the number of home births in the United States rose by 41{\%}, increasing the need for accurate assessment of the safety of planned home birth. This study examines outcomes of planned home births in the United States between 2004 and 2009. Methods: We calculated descriptive statistics for maternal demographics, antenatal risk profiles, procedures, and outcomes of planned home births in the Midwives Alliance of North American Statistics Project (MANA Stats) 2.0 data registry. Data were analyzed according to intended and actual place of birth. Results: Among 16,924 women who planned home births at the onset of labor, 89.1{\%} gave birth at home. The majority of intrapartum transfers were for failure to progress, and only 4.5{\%} of the total sample required oxytocin augmentation and/or epidural analgesia. The rates of spontaneous vaginal birth, assisted vaginal birth, and cesarean were 93.6{\%}, 1.2{\%}, and 5.2{\%}, respectively. Of the 1054 women who attempted a vaginal birth after cesarean, 87{\%} were successful. Low Apgar scores (< 7) occurred in 1.5{\%} of newborns. Postpartum maternal (1.5{\%}) and neonatal (0.9{\%}) transfers were infrequent. The majority (86{\%}) of newborns were exclusively breastfeeding at 6 weeks of age. Excluding lethal anomalies, the intrapartum, early neonatal, and late neonatal mortality rates were 1.30, 0.41, and 0.35 per 1000, respectively. Discussion: For this large cohort of women who planned midwife-led home births in the United States, outcomes are congruent with the best available data from population-based, observational studies that evaluated outcomes by intended place of birth and perinatal risk factors. Low-risk women in this cohort experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes.",
keywords = "Birth place, Home childbirth, Midwife, Midwifery, Perinatal outcome, Pregnancy outcomes",
author = "Melissa Cheyney and Marit Bovbjerg and Courtney Everson and Wendy Gordon and Darcy Hannibal and Saraswathi Vedam",
year = "2014",
month = "1",
day = "1",
doi = "10.1111/jmwh.12172",
language = "English (US)",
volume = "59",
pages = "17--27",
journal = "Journal of Midwifery and Women's Health",
issn = "1526-9523",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Outcomes of care for 16,924 planned home births in the United States

T2 - The midwives alliance of North America statistics project, 2004 to 2009

AU - Cheyney, Melissa

AU - Bovbjerg, Marit

AU - Everson, Courtney

AU - Gordon, Wendy

AU - Hannibal, Darcy

AU - Vedam, Saraswathi

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Introduction: Between 2004 and 2010, the number of home births in the United States rose by 41%, increasing the need for accurate assessment of the safety of planned home birth. This study examines outcomes of planned home births in the United States between 2004 and 2009. Methods: We calculated descriptive statistics for maternal demographics, antenatal risk profiles, procedures, and outcomes of planned home births in the Midwives Alliance of North American Statistics Project (MANA Stats) 2.0 data registry. Data were analyzed according to intended and actual place of birth. Results: Among 16,924 women who planned home births at the onset of labor, 89.1% gave birth at home. The majority of intrapartum transfers were for failure to progress, and only 4.5% of the total sample required oxytocin augmentation and/or epidural analgesia. The rates of spontaneous vaginal birth, assisted vaginal birth, and cesarean were 93.6%, 1.2%, and 5.2%, respectively. Of the 1054 women who attempted a vaginal birth after cesarean, 87% were successful. Low Apgar scores (< 7) occurred in 1.5% of newborns. Postpartum maternal (1.5%) and neonatal (0.9%) transfers were infrequent. The majority (86%) of newborns were exclusively breastfeeding at 6 weeks of age. Excluding lethal anomalies, the intrapartum, early neonatal, and late neonatal mortality rates were 1.30, 0.41, and 0.35 per 1000, respectively. Discussion: For this large cohort of women who planned midwife-led home births in the United States, outcomes are congruent with the best available data from population-based, observational studies that evaluated outcomes by intended place of birth and perinatal risk factors. Low-risk women in this cohort experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes.

AB - Introduction: Between 2004 and 2010, the number of home births in the United States rose by 41%, increasing the need for accurate assessment of the safety of planned home birth. This study examines outcomes of planned home births in the United States between 2004 and 2009. Methods: We calculated descriptive statistics for maternal demographics, antenatal risk profiles, procedures, and outcomes of planned home births in the Midwives Alliance of North American Statistics Project (MANA Stats) 2.0 data registry. Data were analyzed according to intended and actual place of birth. Results: Among 16,924 women who planned home births at the onset of labor, 89.1% gave birth at home. The majority of intrapartum transfers were for failure to progress, and only 4.5% of the total sample required oxytocin augmentation and/or epidural analgesia. The rates of spontaneous vaginal birth, assisted vaginal birth, and cesarean were 93.6%, 1.2%, and 5.2%, respectively. Of the 1054 women who attempted a vaginal birth after cesarean, 87% were successful. Low Apgar scores (< 7) occurred in 1.5% of newborns. Postpartum maternal (1.5%) and neonatal (0.9%) transfers were infrequent. The majority (86%) of newborns were exclusively breastfeeding at 6 weeks of age. Excluding lethal anomalies, the intrapartum, early neonatal, and late neonatal mortality rates were 1.30, 0.41, and 0.35 per 1000, respectively. Discussion: For this large cohort of women who planned midwife-led home births in the United States, outcomes are congruent with the best available data from population-based, observational studies that evaluated outcomes by intended place of birth and perinatal risk factors. Low-risk women in this cohort experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes.

KW - Birth place

KW - Home childbirth

KW - Midwife

KW - Midwifery

KW - Perinatal outcome

KW - Pregnancy outcomes

UR - http://www.scopus.com/inward/record.url?scp=84896691630&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84896691630&partnerID=8YFLogxK

U2 - 10.1111/jmwh.12172

DO - 10.1111/jmwh.12172

M3 - Article

VL - 59

SP - 17

EP - 27

JO - Journal of Midwifery and Women's Health

JF - Journal of Midwifery and Women's Health

SN - 1526-9523

IS - 1

ER -