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Table 3 Labour process among women who started labour in midwife-led care, planned home versus hospital birth

From: Effect of planned place of birth on obstetric interventions and maternal outcomes among low-risk women: a cohort study in the Netherlands

 

Nulliparous (n = 1585)

Parous (n = 1910)

No of events/Births

Incidence (%)

Crude OR (95 % CI)

Adjusted OR (95 % CI) a

No of events/births

Incidence (%)

Crude OR (95 % CI)

Adjusted OR (95 % CI) a

Duration first stage: < 6 h

 Planned home birth

213/825

25.8

0.99 (0.78–1.27)

0.99 (0.76–1.28)

944/1173

80.5

1.89 (1.52–2.35)*

1.74 (1.38–2.19)*

 Planned hospital birth

173/693

25.0

1

1

496/724

68.5

1

1

Duration first stage: > 12 h

 Planned home birth

213/825

25.8

0.85 (0.68–1.08)

0.86 (0.67–1.11)

26/1173

2.2

0.64 (0.36–1.12)

0.69 (0.38–1.25)b

 Planned hospital birth

204/693

29.4

1

1

26/724

3.6

1

1

Duration second stage nulliparous women: ≥ 90 min

 Planned home birth

179/803

21.2

1.57 (1.18–2.09)*

1.38 (1.03–1.1.86)*

    

 Planned hospital birth

94/661

14.2

1

1

    

Duration second stage parous women: ≥ 30 min

 Planned home birth

    

95/1175

8.1

0.69 (0.50–0.95)*

0.65 (0.47–0.91)*

 Planned hospital birth

    

83/715

11.6

1

1

Position during childbirth: non- recumbentc

 Planned home birth

98/579

16.9

1.85 (1.22–2.80)*

1.98 (1.27–3.10)*

138/792

17.7

1.47 (1.03–2.09)*

1.56 (1.08–2.25)*

 Planned hospital birth

45/415

10,8

1

1

55/417

13.4

1

1

Use of pharmacological pain reliefc/d

 Planned home birth

139/584

23.8

0.54 (0.40–72)*

0.53 (0.39–0.72)*

11/800

1.4

0.13 (0.07–0.26)*

0.15 (0.07–0.30)*b

 Planned hospital birth

151/418

36.1

1

1

40/421

9.5

1

1

Transfer of care to obstetrician during labour or directly postpartum

 Planned home birth

509/868

58.6

0.60 (0.48–0.74)*

0.57 (0.45–0.72)*

173/1182

14.6

0.36 (0.28–0.45)*

0.39 (0.31–0.49)*

 Planned hospital birth

499/717

69.6

1

1

236/728

32.4

1

1

Transfer of care to obstetrician during first stage of labour

 Planned home birth

310/868

35.7

0.51 (0.41–0.63)*

0.54 (0.43–0.68)*

110/1182

9.3

0.29 (0.23–0.38)*

0.32 (0.24–0.42)*

 Planned hospital birth

365/717

50.9

1

1

188/728

25.8

1

1

Transfer of care to obstetrician during second stage of labour

 Planned home birth

141/868

16.2

1.11 (0.84–1.45)

0.94 (0.70–1.25)

17/1182

1.4

0.62 (0.31–1.23)

0.63 (0.31–1.30)b

 Planned hospital birth

107/717

14.9

1

1

17/728

2.3

1

1

Transfer of care to obstetrician directly postpartum

 Planned home birth

58/868

6.7

1.62 (1.02–2.58)*

1.70 (1.05–2.77)*b

46/1182

3.9

0.90 (0.56–1.45)

0.96 (0.58–1.57)b

 Planned hospital birth

27/717

3.8

1

1

31/728

4.3

1

1

  1. Multilevel analysis of obstetric interventions and maternal outcomes
  2. *p < 0.05
  3. aAdjusted for maternal age, gestational age, ethnic background (Dutch/western background/non-western background), Body Mass Index (BMI), socio-economic position
  4. bAdjusted for maternal age, ethnic background (Dutch/non-Dutch) and BMI if there were less than 90 cases, to take account to the rule of ten events per variable
  5. cInformation extracted from the third (postpartum) questionnaire (available for N = 2160 women)
  6. dNulliparous women with pharmacological pain relief used intramuscular opioids in 24,1 %, intravenous opioids in 24,5 %, epidural analgesia in 62,8 % or other 4,1 %
  7. Parous women with pharmacological pain relief used intramuscular opioids in 37,3 %, intravenous opioids in 33,3 % and epidural analgesia in 27,5 % or other 11,8 %. Numbers do not count to hundred percent because some women received more than one form of medical pain medication
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BMC Pregnancy and Childbirth

ISSN: 1471-2393

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