Trends in characteristics of women choosing contraindicated home births

Trends in characteristics of women choosing contraindicated home births AbstractObjective:To characterize the American College of Obstetricians and Gynecologists (ACOG) contraindicated home births and the women who are receiving these births in hopes of identifying venues for intervention.Methods:The National Center for Health Statistics (NCHS) birth certificate records from 1990 to 2015 were used. “Planned home births” were defined as those births in which birthplace was coded as “residence” and birth attendant was coded as “certified nurse midwife (CNM)” or “other midwife”. Contraindicated home births were defined as “planned home births” from 1990 to 2015 that had one or more of the ACOG risk factors for home births, which include vaginal birth after prior cesarean delivery (VBAC), breech presentation and multiple gestations.Results:A review of trends in contraindicated home births from 1990 to 2015 suggests that they are increasing in number (481–1396) and as a percentage of total births (0.01%–0.04%, P<0.001). There has been an increase in the proportion of college-educated women (31%–51%, P<0.001). Most women receive prenatal care (>95%), which is most frequently initiated in the first trimester. The majority of home births were paid out-of-pocket (65%–69%).Conclusion:The increasing number of contraindicated home births in the United States requires public health action. Home births are likely a matter of choice rather than a lack of resources. It is unclear if women choose home births while knowing the risk or due to a lack of information. Prenatal education about contraindicated home births is possible, as almost all women receive prenatal care. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Perinatal Medicine de Gruyter

Trends in characteristics of women choosing contraindicated home births

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Publisher
de Gruyter
Copyright
©2018 Walter de Gruyter GmbH, Berlin/Boston
ISSN
1619-3997
eISSN
1619-3997
DOI
10.1515/jpm-2018-0029
Publisher site
See Article on Publisher Site

Abstract

AbstractObjective:To characterize the American College of Obstetricians and Gynecologists (ACOG) contraindicated home births and the women who are receiving these births in hopes of identifying venues for intervention.Methods:The National Center for Health Statistics (NCHS) birth certificate records from 1990 to 2015 were used. “Planned home births” were defined as those births in which birthplace was coded as “residence” and birth attendant was coded as “certified nurse midwife (CNM)” or “other midwife”. Contraindicated home births were defined as “planned home births” from 1990 to 2015 that had one or more of the ACOG risk factors for home births, which include vaginal birth after prior cesarean delivery (VBAC), breech presentation and multiple gestations.Results:A review of trends in contraindicated home births from 1990 to 2015 suggests that they are increasing in number (481–1396) and as a percentage of total births (0.01%–0.04%, P<0.001). There has been an increase in the proportion of college-educated women (31%–51%, P<0.001). Most women receive prenatal care (>95%), which is most frequently initiated in the first trimester. The majority of home births were paid out-of-pocket (65%–69%).Conclusion:The increasing number of contraindicated home births in the United States requires public health action. Home births are likely a matter of choice rather than a lack of resources. It is unclear if women choose home births while knowing the risk or due to a lack of information. Prenatal education about contraindicated home births is possible, as almost all women receive prenatal care.

Journal

Journal of Perinatal Medicinede Gruyter

Published: Aug 28, 2018

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