General practice

Outcome of planned home and planned hospital births in low risk pregnancies: prospective study in midwifery practices in the Netherlands

^a NIVEL (Netherlands Institute of Primary Health Care), PO Box 1568, 3500 BN Utrecht, Netherlands, ^b Department of Obstetrics and Gynaecology, Flinders University of South Australia, Flinders Medical Centre, GPO Box 2100, Adelaide, SA 5001, Australia

Correspondence to: Mrs Wiegers.

Abstract

Objective: To investigate the relation between the intended place of birth (home or hospital) and perinatal outcome in women with low risk pregnancies after controlling for parity and social, medical, and obstetric background.
Design: Analysis of prospective data from midwives and their clients.
Setting: 54 midwifery practices in the province of Gelderland, Netherlands.
Subjects: 97 midwives and 1836 women with low risk pregnancies who had planned to give birth at home or in hospital.
Main outcome measure: Perinatal outcome index based on "maximal result with minimal intervention" and incorporating 22 items on childbirth, 9 on the condition of the newborn, and 5 on the mother after the birth.
Results: There was no relation between the planned place of birth and perinatal outcome in primiparous women when controlling for a favourable or less favourable background. In multiparous women, perinatal outcome was significantly better for planned home births than for planned hospital births, with or without control for background variables.
Conclusions: The outcome of planned home births is at least as good as that of planned hospital births in women at low risk receiving midwifery care in the Netherlands.

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