Birth Outcomes for Women Using Free-Standing Birth Centers in South Aukland, New Zealand (Bailey, 2017)
Bailey, David John, “Birth Outcomes for Women Using Free-Standing Birth Centers in South Aukland, New Zealand, Birth 44, no.3 (May 2017), doi:10.1111/birt.12287
URL: onlinelibrary.wiley.com/doi/10.1111/birt.12287/full/
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Abstract
Background: This study investigates maternal and perinatal outcomes for women with low-risk pregnancies laboring in free-standing birth centers compared with laboring in a hospital maternity unit in a large New Zealand health district.
Methods: The study used observational data from 47,381 births to women with low-risk pregnancies in South Auckland maternity facilities 2003-2010. Adjusted odds ratios with 95% confidence intervals were calculated for instrumental delivery, cesarean section, blood transfusion, neonatal unit admission, and perinatal mortality.
Results: Labor in birth centers was associated with significantly lower rates of instrumental delivery, cesarean section and blood transfusion compared with labor in hospital. Neonatal unit admission rates were lower for infants of nulliparous women laboring in birth centers. Intrapartum and neonatal mortality rates for birth centers were low and were not significantly different from the hospital population. Transfers to hospital for labor and postnatal complications occurred in 39% of nulliparous and 9% of multiparous labors. Risk factors identified for transfer were nulliparity, advanced maternal age, and prolonged pregnancy ≥41 weeks’ gestation.
Conclusions: Labor in South Auckland free-standing birth centers was associated with significantly lower maternal intervention and complication rates than labor in the hospital maternity unit and was not associated with increased perinatal morbidity.
Bailey (2017) notes that where women give birth when their pregnancy has a low risk of complications has been debated amongst professionals for years. While the debate is likely to continue, the growing evidence supporting the safety and success of free-standing birth centers for low-risk women could provide greater access to safe birthing methods for women in low- and middle-income countries if properly implemented.
