Get access

Birth Centers in Australia: A National Population-Based Study of Perinatal Mortality Associated with Giving Birth in a Birth Center

Authors

  • Sally K Tracy DMid, RM,

    Corresponding author
    1. 1Sally K. Tracy is an Associate Professor Midwifery, 2Paula Laws and Yueping Alex Wang are Senior Research Officers, and 3Elizabeth Sullivan is a Director in the Australian Institute of Health and Welfare National Perinatal Statistics Unit at the University of New South Wales, Sydney; 4Hannah Dahlen is a Clinical Midwife Consultant at the Royal Prince Alfred and Canterbury Hospitals, Sydney; 5Shea Caplice is a Clinical Midwifery Consultant at the Royal Hospital for Women, Sydney; and 6Mark Tracy is a Director in the Neonatal Intensive Care Unit at the Nepean Hospital, Sydney, New South Wales, Australia.
    Search for more papers by this author
  • 1 Hannah Dahlen M(CommN), RM,

    1. 1Sally K. Tracy is an Associate Professor Midwifery, 2Paula Laws and Yueping Alex Wang are Senior Research Officers, and 3Elizabeth Sullivan is a Director in the Australian Institute of Health and Welfare National Perinatal Statistics Unit at the University of New South Wales, Sydney; 4Hannah Dahlen is a Clinical Midwife Consultant at the Royal Prince Alfred and Canterbury Hospitals, Sydney; 5Shea Caplice is a Clinical Midwifery Consultant at the Royal Hospital for Women, Sydney; and 6Mark Tracy is a Director in the Neonatal Intensive Care Unit at the Nepean Hospital, Sydney, New South Wales, Australia.
    Search for more papers by this author
  • 4 Shea Caplice MMid, RM,

    1. 1Sally K. Tracy is an Associate Professor Midwifery, 2Paula Laws and Yueping Alex Wang are Senior Research Officers, and 3Elizabeth Sullivan is a Director in the Australian Institute of Health and Welfare National Perinatal Statistics Unit at the University of New South Wales, Sydney; 4Hannah Dahlen is a Clinical Midwife Consultant at the Royal Prince Alfred and Canterbury Hospitals, Sydney; 5Shea Caplice is a Clinical Midwifery Consultant at the Royal Hospital for Women, Sydney; and 6Mark Tracy is a Director in the Neonatal Intensive Care Unit at the Nepean Hospital, Sydney, New South Wales, Australia.
    Search for more papers by this author
  • 5 Paula Laws BAppPsych(Hons),

    1. 1Sally K. Tracy is an Associate Professor Midwifery, 2Paula Laws and Yueping Alex Wang are Senior Research Officers, and 3Elizabeth Sullivan is a Director in the Australian Institute of Health and Welfare National Perinatal Statistics Unit at the University of New South Wales, Sydney; 4Hannah Dahlen is a Clinical Midwife Consultant at the Royal Prince Alfred and Canterbury Hospitals, Sydney; 5Shea Caplice is a Clinical Midwifery Consultant at the Royal Hospital for Women, Sydney; and 6Mark Tracy is a Director in the Neonatal Intensive Care Unit at the Nepean Hospital, Sydney, New South Wales, Australia.
    Search for more papers by this author
  • 2 Yueping Alex Wang MPH,

    1. 1Sally K. Tracy is an Associate Professor Midwifery, 2Paula Laws and Yueping Alex Wang are Senior Research Officers, and 3Elizabeth Sullivan is a Director in the Australian Institute of Health and Welfare National Perinatal Statistics Unit at the University of New South Wales, Sydney; 4Hannah Dahlen is a Clinical Midwife Consultant at the Royal Prince Alfred and Canterbury Hospitals, Sydney; 5Shea Caplice is a Clinical Midwifery Consultant at the Royal Hospital for Women, Sydney; and 6Mark Tracy is a Director in the Neonatal Intensive Care Unit at the Nepean Hospital, Sydney, New South Wales, Australia.
    Search for more papers by this author
  • 2 Mark B. Tracy MBBS, MSc(Epi),

    1. 1Sally K. Tracy is an Associate Professor Midwifery, 2Paula Laws and Yueping Alex Wang are Senior Research Officers, and 3Elizabeth Sullivan is a Director in the Australian Institute of Health and Welfare National Perinatal Statistics Unit at the University of New South Wales, Sydney; 4Hannah Dahlen is a Clinical Midwife Consultant at the Royal Prince Alfred and Canterbury Hospitals, Sydney; 5Shea Caplice is a Clinical Midwifery Consultant at the Royal Hospital for Women, Sydney; and 6Mark Tracy is a Director in the Neonatal Intensive Care Unit at the Nepean Hospital, Sydney, New South Wales, Australia.
    Search for more papers by this author
  • and 6 Elizabeth Sullivan MBBS, MPH 3

    1. 1Sally K. Tracy is an Associate Professor Midwifery, 2Paula Laws and Yueping Alex Wang are Senior Research Officers, and 3Elizabeth Sullivan is a Director in the Australian Institute of Health and Welfare National Perinatal Statistics Unit at the University of New South Wales, Sydney; 4Hannah Dahlen is a Clinical Midwife Consultant at the Royal Prince Alfred and Canterbury Hospitals, Sydney; 5Shea Caplice is a Clinical Midwifery Consultant at the Royal Hospital for Women, Sydney; and 6Mark Tracy is a Director in the Neonatal Intensive Care Unit at the Nepean Hospital, Sydney, New South Wales, Australia.
    Search for more papers by this author

  • Source of funding for this study was the National Health and Medical Research Council of Australia, Population Health Capacity Building Grant: Health Research and Outcomes Network, Sydney, New South Wales, Australia.

Dr. Sally K. Tracy, DMid, RM, Australian Institute of Health and Welfare National Perinatal Statistics Unit, School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW 2031, Australia.

Abstract

ABSTRACT: Background: Perinatal mortality is a rare outcome among babies born at term in developed countries after normal uncomplicated pregnancies; consequently, the numbers involved in large databases of routinely collected statistics provide a meaningful evaluation of these uncommon events. The National Perinatal Data Collection records the place of birth and information on the outcomes of pregnancy and childbirth for all women who give birth each year in Australia. Our objective was to describe the perinatal mortality associated with giving birth in “alongside hospital” birth centers in Australia during 1999 to 2002 using nationally collected data. Methods: This population-based study included all 1,001,249 women who gave birth in Australia during 1999 to 2002. Of these women, 21,800 (2.18%) gave birth in a birth center. Selected perinatal outcomes (including stillbirths and neonatal deaths) were described for the 4-year study period separately for first-time mothers and for women having a second or subsequent birth. A further comparison was made between deaths of low-risk term babies born in hospitals compared with deaths of term babies born in birth centers. Results: The total perinatal death rate attributed to birth centers was significantly lower than that attributed to hospitals (1.51/1,000 vs 10.03/1,000). The perinatal mortality rate among term births to primiparas in birth centers compared with term births among low-risk primiparas in hospitals was 1.4 versus 1.9 per 1,000; the perinatal mortality rate among term births to multiparas in birth centers compared with term births among low-risk multiparas in hospitals was 0.6 versus 1.6 per 1,000. Conclusions: This study using Australian national data showed that the overall rate of perinatal mortality was lower in alongside hospital birth centers than in hospitals irrespective of the mother’s parity. (BIRTH 34:3 September 2007)

Ancillary