Is home birth safe?

We will discuss “Perinatal mortality and morbidity up to 28 days after birth among 743 070 low-risk planned home and hospital births: a cohort study based on three merged national perinatal databases” by de Jong and co-workers from 29 July 2015 for 7 days.

*This paper will be made FREE-TO-VIEW on 15 June 2015.

There are two linked commentaries with this #BlueJC paper:

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Start date: 29 July 2015 (the discussion will open for 7 days between 29 July 2015 to 5 August)

First hosted discussion session(s) starts at: BST 7pm (UK time)

Host: @jimgthornton (Prof. Thornton, University of Nottingham) and @BlueJCHost

Platforms: Twitter and LinkedIn

BJOG_BlueJC_160x600WebBanner_Mar15_(reoriented)_3The Blue Journal Club is an international journal club on women’s health research based on Twitter (as @BlueJCHost). We start our conversation on the last Wednesday of every month and use the hashtag #BlueJC for our tweets. Simply add this hashtag (“#BlueJC”) to each tweet and we will capture it. Each #BlueJC opens for 7 days with an advertised start time. All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues. You can access the slide set of this paper here (data S1).

The discussion points are attached below (quoted from the published manuscript)

Scenario

A 28-year-old nulliparous woman comes to see her midwife at 36 week of her pregnancy. She has an uncomplicated pregnancy to date and no other medical history. She asks, “can I have a home birth?”

Description of research

Participants

Low-risk women in midwife-led care

Intervention

Planned home birth

Comparison

Planned hospital birth

Outcomes

Intrapartum and neonatal death, Apgar scores, and admission to a neonatal intensive care unit (NICU) within 28 days of birth

Study design

A nationwide cohort study, using national registration data

Discussion Points

  • In your practice, how common is home birth?
  • Which additional factors health professionals need to consider when counseling the woman in the scenario?
  • According to this study, what are the risks of home birth in nulliparous women? Compare these risks in multiparous woman.
  • How do the results of this study different from the Birthplace Study?
  • What are the strengths and weaknesses of this cohort study?
  • How do the results of this study cognate with the recommendations on the place of birth by the National Institute for Health and Care Excellence (NICE CG190)?
  • Are the results of this study generalisable in different healthcare settings?
  • Are randomised controlled trials appropriate to determine safety of home birth?
  • How would the results of this study influence your daily practice?

Suggested reading

  • Brocklehurst P, Hardy P, Hollowell J, Linsell L, Macfarlane A, McCourt C, et al. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ 2011;343:d7400.
  • Chervenak FA, McCullough LB, Arabin B, Brent RL, Levene MI, Grünebaum A. Planned homebirth: not a Dutch treat for export. BJOG. 2015 Apr;122(5):730.
  • Knight M. How should we interpret the new Dutch evidence on home birth? BJOG. 2015 Apr;122(5):729.
  • The National Institute for Health and Care Excellence. Intrapartum Care (CG190). Available from: nice.org.uk/Guidance/CG190/Evidence
  • Olsen O, Clausen JA. Planned hospital birth versus planned home birth. Cochrane Database Syst Rev. 2012 Sep 12;9:CD000352.

For those who want to understand hashtags, this may be a useful guide. For an introduction to #BlueJC, please refer to BJOG 2013;120:657–60. Follow @BlueJCHostthis blog and our Facebook page to receive news about #BlueJC.