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Perinatal Outcomes of Women Intending to Give Birth in Birth Centers in Australia

Authors

  • Paula J. Laws BAppPsych (Hons),

    1. Paula Laws is Senior Research Officer, Perinatal and Reproductive Epidemiology Research Unit, School of Women’s and Children’s Health, University of New South Wales; Sally Tracy is Professor of Midwifery, University of Sydney; and Elizabeth Sullivan is Associate Professor and Director, Perinatal and Reproductive Epidemiology Research Unit, School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia.
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  • Sally K. Tracy DMid, RM,

    1. Paula Laws is Senior Research Officer, Perinatal and Reproductive Epidemiology Research Unit, School of Women’s and Children’s Health, University of New South Wales; Sally Tracy is Professor of Midwifery, University of Sydney; and Elizabeth Sullivan is Associate Professor and Director, Perinatal and Reproductive Epidemiology Research Unit, School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia.
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  • Elizabeth A. Sullivan MBBS, MPH, MMed

    1. Paula Laws is Senior Research Officer, Perinatal and Reproductive Epidemiology Research Unit, School of Women’s and Children’s Health, University of New South Wales; Sally Tracy is Professor of Midwifery, University of Sydney; and Elizabeth Sullivan is Associate Professor and Director, Perinatal and Reproductive Epidemiology Research Unit, School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia.
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  • This article is based on data made available by the Australian Institute of Health and Welfare (Canberra, Australian Capital Territory). The authors are responsible for the use of the data in this article.

Address correspondence to Paula Laws, BAppPsych (Hons), Perinatal and Reproductive Epidemiology Research Unit, Level 2, McNevin Dickson Building, Randwick Hospitals Campus, Randwick, NSW 2031, Australia.

Abstract

Abstract:  Background:  A recent Australian study showed perinatal mortality was lower among women who gave birth in a birth center than in a comparable low-risk group of women who gave birth in a hospital. The current study used the same large population database to investigate whether perinatal outcomes were improved for women intending to give birth in a birth center at the onset of labor, regardless of the actual place of birth.

Methods:  Data were obtained from the National Perinatal Data Collection (NPDC) in Australia. The study included 822,955 mothers who gave birth during the 5-year period, 2001 to 2005, and their 836,919 babies. Of these, 22,222 women (2.7%) intended to give birth in a birth center at the onset of labor. Maternal and perinatal factors and outcomes were compared according to the intended place of birth. Data were not available on congenital anomalies, or cause, or timing of death.

Results:  Women intending to give birth in a birth center at the onset of labor had lower rates of intervention and of adverse perinatal outcomes compared with women intending to give birth in a hospital, including less preterm birth and low birthweight. No statistically significant difference was found in perinatal mortality for term babies of mothers intending to give birth in a birth center compared with term babies of low-risk women intending to give birth in a hospital (1.3 per 1,000 births [99% CI = 0.66, 1.95] vs 1.7 per 1,000 births [99% CI = 1.50, 1.80], respectively).

Conclusions:  Term babies of women who intended to give birth in a birth center were less likely to be admitted to a neonatal intensive care unit or special care nursery, and no significant difference was found in other perinatal outcomes compared with term babies of low-risk women who intended to give birth in a hospital labor ward. Birth center care remains a viable option for eligible women giving birth at term. (BIRTH 37:1 March 2010)

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