Patricia Janssen, PhD is an Assistant Professor in the Department of Health Care and Epidemiology at the University of British Columbia and an Associate Faculty member in the Department of Family Practice and the School of Nursing. She is an Associate Faculty member at the B.C. Research Institute for Children's and Women's Health.
An Evaluation of Process and Protocols for Planned Home Birth Attended by Regulated Midwives in British Columbia
Version of Record online: 24 DEC 2010
2003 American College of Nurse Midwives
Journal of Midwifery & Womens Health
Volume 48, Issue 2, pages 138–145, March-April 2003
How to Cite
Janssen, P. A., Lee, S. K., Ryan, E. R. and Saxell, L. (2003), An Evaluation of Process and Protocols for Planned Home Birth Attended by Regulated Midwives in British Columbia. Journal of Midwifery & Womens Health, 48: 138–145. doi: 10.1016/S1526-9523(02)00418-X
- Issue online: 24 DEC 2010
- Version of Record online: 24 DEC 2010
- home childbirth;
- outcomes assessment
Midwifery emerged as a self-regulated profession in British Columbia in the context of a 2-year demonstration project beginning in 1998. The project evaluated accountability among midwives, defined as the provision of safe and appropriate care and maintenance of standards of communication set by the College of Midwives of British Columbia. Adherence to protocols was measured by using documentation designed specifically for the Home Birth Demonstration Project. Hospital and transport records for selected clients were reviewed by an expert committee. Outcomes among Home Birth Demonstration Project clients were compared with outcomes among women eligible for home birth but planning to deliver in hospital. Adherence to clinical and communication protocols was 96% or higher. Planned home birth was not associated with an increase in risk but prevalence of adverse outcomes was too low to be studied with precision. Recommendations of an expert review committee have been implemented or are under review. Midwives have demonstrated a high degree of compliance with reporting requirements and protocols. Comparisons of birth outcomes of planned home versus hospital births, while supporting home birth as a choice for women, were limited in scope and require ongoing study. Integration of home birth has been a dynamic process with guidelines and policy continuing to evolve.