Title
Differences in optimality index between planned place of birth in a birth centre and alternative planned places of birth, a nationwide prospective cohort study in The Netherlands: Results of the Dutch Birth Centre Study
Author
Hermus, M.A.A.
Hitzert, M.
Boesveld, I.I.
van den Akker-van Marle, E.M.
van Dommelen, P.
Franx, A.
de Graaf, J.P.
van Lith, J.M.M.
Steegers, E.E.
Wiegers, T.A.
van der Pal-de Bruin, K.K.
Publication year
2017
Abstract
Objectives To compare the Optimality Index of planned birth in a birth centre with planned birth in a hospital and planned home birth for low-risk term pregnant women who start labour under the responsibility of a community midwife. Design Prospective cohort study. Setting Low-risk pregnant women under care of a community midwife and living in a region with one of the 21 participating Dutch birth centres or in a region with the possibility for midwife-led hospital birth. Home birth was commonly available in all regions included in the study. Participants 3455 low-risk term pregnant women (1686 nulliparous and 1769 multiparous) who gave birth between 1 July 2013 and 31 December 2013: 1668 planned birth centre births, 701 planned midwife-led hospital births and 1086 planned home births. Main outcome measurements The Optimality IndexNL-2015, a tool to measure ‘maximum outcome with minimal intervention’, was assessed by planned place of birth being a birth centre, a hospital setting or at home. Also, a composite maternal and perinatal adverse outcome score was calculated for the different planned places of birth. Results There were no differences in Optimality Index NL-2015 for pregnant women who planned to give birth in a birth centre compared with women who planned to give birth in a hospital. Although effect sizes were small, women who planned to give birth at home had a higher Optimality Index NL-2015 than women who planned to give birth in a birth centre. The differences were larger for multiparous than for nulliparous women. Conclusion The Optimality Index NL-2015 for women with planned birth centre births was comparable with planned midwife-led hospital births. Women with planned home births had a higher Optimality Index NL-2015, that is, a higher sum score of evidence-based items with an optimal value than women with planned birth centre births.
Subject
Life
CH - Child Health
ELSS - Earth, Life and Social Sciences
Healthy for Life
Health
Healthy Living
Midwife-led units
Outcome assessment
Midwife-led units
Epidemiology
Home delivery
Maternity ward
Midwife
Obstetric delivery
Parity
Patient preference
Pregnancy
Pregnancy outcome
Prospective study
Psychology
Standards
Statistics and numerical data
Treatment outcome
Adult
Birthing Centers
Delivery Rooms
Delivery, Obstetric
Female
Home Childbirth
Humans
Midwifery
Netherlands
Outcome and Process Assessment (Health Care)
Parity
Patient Preference
Pregnancy
Pregnancy Outcome
Prospective Studies
To reference this document use:
http://resolver.tudelft.nl/uuid:cdc204c3-271b-41fb-9ff6-4b352f5b9d93
DOI
https://doi.org/10.1136/bmjopen-2017-016958
TNO identifier
782119
ISSN
1568-4156
Source
BMJ Open, 7 (11), e016958
Document type
article