The University of Southampton
University of Southampton Institutional Repository

The methodological challenges of attempting to compare the safety of home and hospital birth in terms of the risk of perinatal death

The methodological challenges of attempting to compare the safety of home and hospital birth in terms of the risk of perinatal death
The methodological challenges of attempting to compare the safety of home and hospital birth in terms of the risk of perinatal death
This paper identifies a number of methodological difficulties associated with the comparison of home and hospital birth in terms of the risk of perinatal death, and suggests ways in which these problems can be overcome. A review of recent studies suggests that most available data sources are unable to overcome all of these challenges, which is one of the reasons why the debate about whether perinatal death is more likely if a home birth is planned or if a hospital birth is planned has not been satisfactorily resolved. We argue that the debate will be settled only if perinatal mortality data from a sufficiently large number of maternity care providers over a sufficiently long period of time can be pooled and made available for analysis. The pooling of data will bring about its own difficulties due to variations over time and between providers and geographical areas, which would need to be taken into account when analysing pooled data. However, given the impracticality of a randomised controlled trial and the rarity of home birth in most of the Western world, we argue that more effort should be made to pool data for perinatal mortality and other rare pregnancy outcomes, and share them between health providers and researchers. Thus, high-quality analyses could be conducted, allowing all women to make an informed choice about place of birth. However, pooling data from countries or states with very different maternity care systems should be avoided.
home childbirth, research design, perinatal mortality
0266-6138
619-626
Nove, Andrea
91c50c0f-ae3d-482f-b5f0-f981d703c0fe
Berrington, Ann
bd0fc093-310d-4236-8126-ca0c7eb9ddde
Matthews, Zoë
ebaee878-8cb8-415f-8aa1-3af2c3856f55
Nove, Andrea
91c50c0f-ae3d-482f-b5f0-f981d703c0fe
Berrington, Ann
bd0fc093-310d-4236-8126-ca0c7eb9ddde
Matthews, Zoë
ebaee878-8cb8-415f-8aa1-3af2c3856f55

Nove, Andrea, Berrington, Ann and Matthews, Zoë (2012) The methodological challenges of attempting to compare the safety of home and hospital birth in terms of the risk of perinatal death. [in special issue: Place of Birth] Midwifery, 28 (5), 619-626. (doi:10.1016/j.midw.2012.07.009). (PMID:22951423)

Record type: Article

Abstract

This paper identifies a number of methodological difficulties associated with the comparison of home and hospital birth in terms of the risk of perinatal death, and suggests ways in which these problems can be overcome. A review of recent studies suggests that most available data sources are unable to overcome all of these challenges, which is one of the reasons why the debate about whether perinatal death is more likely if a home birth is planned or if a hospital birth is planned has not been satisfactorily resolved. We argue that the debate will be settled only if perinatal mortality data from a sufficiently large number of maternity care providers over a sufficiently long period of time can be pooled and made available for analysis. The pooling of data will bring about its own difficulties due to variations over time and between providers and geographical areas, which would need to be taken into account when analysing pooled data. However, given the impracticality of a randomised controlled trial and the rarity of home birth in most of the Western world, we argue that more effort should be made to pool data for perinatal mortality and other rare pregnancy outcomes, and share them between health providers and researchers. Thus, high-quality analyses could be conducted, allowing all women to make an informed choice about place of birth. However, pooling data from countries or states with very different maternity care systems should be avoided.

Text
Nove_et_al_published_on_line_in_Midwifery.pdf - Other
Restricted to Repository staff only
Request a copy

More information

Published date: October 2012
Keywords: home childbirth, research design, perinatal mortality
Organisations: Social Statistics & Demography

Identifiers

Local EPrints ID: 342451
URI: http://eprints.soton.ac.uk/id/eprint/342451
ISSN: 0266-6138
PURE UUID: 1d04c380-0c35-4942-bb2f-15911da499b0
ORCID for Ann Berrington: ORCID iD orcid.org/0000-0002-1683-6668
ORCID for Zoë Matthews: ORCID iD orcid.org/0000-0003-1533-6618

Catalogue record

Date deposited: 30 Aug 2012 08:42
Last modified: 15 Mar 2024 02:48

Export record

Altmetrics

Contributors

Author: Andrea Nove
Author: Ann Berrington ORCID iD
Author: Zoë Matthews ORCID iD

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×