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Sensitivity analyses were performed to assess the robustness . We assessed whether performing a meta-analyses was appropriate. StatDirect (Version 2.7.9; Cheshire, UK) was used for analyses. I would like to respectfully disagree with your opinion on Meconium stained waters alone being a valid reason for transfer.
She hopes insurance companies will consider the benefits of home-birth and future plans will cover the costs. "Some feel more at ease in the hospital because they know the experts are there. It gives them a lot of security and assurance," Lamar said. "But, a lot of us feel like a duck out of water in the hospital. It's very unfamiliar. When you're on your home turf, and you're there with your family, it really does change the dynamic." I decided to consult a woman who specializes in high-risk pregnancies.
High blood pressure during home birth
Between 1.7% and 7.3% of women and neonates were transferred to hospital after birth. Four studies provided analyses stratified for parity; between 1.6% and 8.9% of nulliparous women and between 1.6% and 5.5% of the multiparous women were transferred after birth. Nine of the 15 included studies described the time span for transfers after birth, and this time varied from 2 hours to 5 days. The 15 studies included a total of 215,257 women with a planned home birth upon onset of labour.
Because of heterogeneity and lack of robustness across the studies, there were considerable risks for bias if performing meta-analyses of the prevalence of transfers . We detected considerable heterogeneity across the studies through reading the studies, and inspecting tables and forest plots. The reason for this finding is probably because of differences in study populations and clinical practice (e.g., guidelines and traditions for transfer indications). After screening titles and abstracts, 76 studies were retrieved in full text.
Births in the U.S.
Pregnant individuals who give birth at home have a higher risk of postpartum hemorrhage and blood transfusions. When the maternal risk level is not adequately assessed for a home birth, it may increase the risk of low Apgar scores, neonatal seizures, and the rate of neonatal mortality. Severe perineal lacerations are a potential risk during hospital births. These are vaginal tears that occur when the birth progresses quickly and the vagina doesn't have time to stretch. A third-degree tear involves the muscles of the anus and rectum, and a fourth-degree tear may extend into the lining of the anus or rectum.
It all depends on the individual circumstances, and on how well you understand the suggested reason for transfer, and whether you agree with it. It is relatively rare for an emergency situation to arise which requires immediate transfer and very urgent hospital treatment, although this is always a possibility. Usually the mother or midwife realise that things are not straightforward well before an emergency arises, so that by the time any action is needed, they have been in hospital for some time. The baby's heart rate might not be responding perfectly to contractions, for example.
Severe tearing after birth
We also used the “PRISMA statement”, which recommends preferred reporting items for systematic reviews and meta-analyses . The mission of the Midwives Alliance of North America is to unite, strengthen, support and advocate for the midwifery community and to promote educational, economic, and cultural sustainability of the midwifery profession. Cord prolapse is a very rare phenomenon where the umbilical cord falls below baby’s head. If this does happen, it causes a lack of blood flow to your baby.
For those experiencing a higher risk pregnancy, such as high blood pressure, unusual fetal growth, uncontrolled diabetes, or some other chronic health conditions a homebirth may not be a safe choice. With the rise of germ theory, obstetrical forceps, and the availability of drugs for pain relief, birth in hospital became more and more popular. I am still trying to figure out why I have regret about my transfer to the hospital for the birth of my second. She was a successful VBAC baby and I thought that was my goal by selecting a homebirth in the first place.
Figures from The Ministry of Health’s Report on Maternity in 2010 show:
The reasons for accepting high-risk cases in home birth settings should be further explored. This raises the issue of whether independent midwives are more willing to accept such women, or whether the women themselves are exerting pressure on midwives to accept them for home birth. In 2010, a meta-analysis Maternal and newborn outcomes in planned home birth vs planned hospital births looked at data from 7 earlier studies . Just as the 2013 study above – the initial findings showed a higher neonatal death rate for out-of-hospital birth when all types of birth attendants were included. But when they isolated the data for CNM-attended births, they found no statistical difference in safety outcomes between home and hospital births.
Verywell Family's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Whether you’re looking to get your pre-licensure degree or taking the next step in your career, the education you need could be more affordable than you think. The most common type of hospital-acquired infections are skin infections caused by methicillin-sensitive or methicillin-resistant Staphylococcus aureus. These can occur on the umbilical stump, nose, or groin and may not be evident until after discharge. The neonatal period is the most vulnerable, especially within the first week of life.
Katherine planned a homebirth for her first baby, but accepted a hospital induction at nearly 3 weeks past her estimated due date. Unfortunately her induction did not progress and ended in a caesarean. This is the story of her second labour, for which she planned a home VBAC .
However, this baby was in there for the duration too, so Katherine again accepted an induction in hospital when she reached 14 days past her EDD - this time with much happier results. A very positive experience of hospital induction - and for all of us planning homebirth, it's good to know that if Plan A doesn't work out, Plan B can still be a triumph. Chris C gave birth to her second baby at home, on a lovely home-made birthing nest, and the birth itself went very well.
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