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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