Nurse Midwifery at Home

9. Outcomes of intended home births in nurse-midwifery practice: a prospective descriptive study

Murphy PA; Fullerton J (Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.

Obstet Gynecol, 92(3):461-70, September 1998

The pregnancies of 1,404 women planning a home birth with 29 US nurse-midwifery practices were studied in 1994-5. 6% miscarried, terminated the pregnancy or changed plans. 7.4% were referred for planned hospital birth during the pregnancy. Of the remaining 86.6% who still planned home births, 102 (8.3%) were transferred to the hospital during labor. Ten mothers (0.8%) were transferred to the hospital after delivery, and 14 infants (1.1%) were transferred after birth. The proportion of babies in this group which died during labour or shortly after birth was 2.5 per 1000. For women actually delivering at home (those who did not transfer), the rate was 1.8 per 1000. Conclusion: ‘Home birth can be accomplished with good outcomes under the care of qualified practitioners and within a system that facilitates transfer to hospital care when necessary. Intrapartal mortality during intended home birth is concentrated in postdates pregnancies with evidence of meconium passage.’¬†Abstract¬†on Medline

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