Education And Debate

Trial would not answer key question, but data monitoring should be improved

BMJ 1996; 312 doi: (Published 23 March 1996) Cite this as: BMJ 1996;312:754
  1. Alison Macfarlane, medical statisticiana
  1. a National Perinatal Epidemiology Unit, Radcliffe Infirmary, Oxford OX2 6HE

    To ask whether there should be a trial of home versus hospital delivery puts the cart before the horse, by proposing a method before deciding on the question that needs to be answered.

    Comparisons between the settings are hampered by the lack of unique and universal definitions of home birth and hospital birth, the differences relating not only to the characteristics of the locations but to the roles of the midwives, general practitioners, and hospital doctors who are giving care. Even within the United Kingdom, care for home births can be given by NHS or independent midwives, with varying participation of general practitioners and hospital doctors and varying contact with hospital maternity units. Similarly, hospitals, which range …

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