Transfers to hospital in planned home birth in four Nordic countries: a prospective cohort study

Ellen Blix; Merethe H Kumle; Karen Ingversen; Anette S Huitfeldt; Hanne K Hegaard; Ólöf Á Ólafsdóttir; Pål Øian; Helena Lindgren

doi:10.1111/aogs.12858

Transfers to hospital in planned home birth in four Nordic countries: a prospective cohort study

Ellen Blix, Merethe H Kumle, Karen Ingversen, Anette S Huitfeldt, Hanne K Hegaard, Ólöf Á Ólafsdóttir, Pål Øian, Helena Lindgren

Department of Clinical Medicine

26 Citations (Scopus)

Abstract

INTRODUCTION: Women planning a home birth are transferred to hospital in case of complications or elevated risk for adverse outcomes. The aim of the present study was to describe the indications for transfer to hospital in planned home births, and the proportion of cases in which this occurs.

MATERIAL AND METHODS: Women in Norway, Sweden, Denmark and Iceland who had opted for, and were accepted for, home birth at the onset of labor, were included in the study. Data from 3068 women, 572 nulliparas and 2446 multiparas, were analyzed for proportion of transfers during labor and within 72 h after birth, indications for transfer, how long before or after birth the transfer started, time from birth to start of transfer, duration and mode of transfer, and whether the transfer was classified as potentially urgent. Analyses were stratified for nulliparity and multiparity.

RESULTS: One-third (186/572) of the nulliparas were transferred to hospital, 137 (24.0%) during labor and 49 (8.6%) after the birth. Of the multiparas, 195/2446 (8.0%) were transferred, 118 (4.8%) during labor and 77 (3.2%) after birth. The most common indication for transfers during labor was slow progress. In transfers after birth, postpartum hemorrhage, tears and neonatal respiratory problems were the most common indications. A total of 116 of the 3068 women had transfers classified as potentially urgent.

CONCLUSIONS: One-third of all nulliparous and 8.0% of multiparous women were transferred during labor or within 72 h of the birth. The proportion of potentially urgent transfers was 3.8%.

Original language	English
Journal	Acta Obstetricia et Gynecologica Scandinavica
Volume	95
Issue number	4
Pages (from-to)	420-8
Number of pages	9
ISSN	0001-6349
DOIs	https://doi.org/10.1111/aogs.12858
Publication status	Published - 1 Apr 2016

Keywords

Adult
Female
Home Childbirth
Hospitalization
Humans
Obstetric Labor Complications
Patient Transfer
Pregnancy
Pregnancy Outcome
Prospective Studies
Registries
Risk
Scandinavian and Nordic Countries
Journal Article
Research Support, Non-U.S. Gov't

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title = "Transfers to hospital in planned home birth in four Nordic countries: a prospective cohort study",

abstract = "INTRODUCTION: Women planning a home birth are transferred to hospital in case of complications or elevated risk for adverse outcomes. The aim of the present study was to describe the indications for transfer to hospital in planned home births, and the proportion of cases in which this occurs.MATERIAL AND METHODS: Women in Norway, Sweden, Denmark and Iceland who had opted for, and were accepted for, home birth at the onset of labor, were included in the study. Data from 3068 women, 572 nulliparas and 2446 multiparas, were analyzed for proportion of transfers during labor and within 72 h after birth, indications for transfer, how long before or after birth the transfer started, time from birth to start of transfer, duration and mode of transfer, and whether the transfer was classified as potentially urgent. Analyses were stratified for nulliparity and multiparity.RESULTS: One-third (186/572) of the nulliparas were transferred to hospital, 137 (24.0%) during labor and 49 (8.6%) after the birth. Of the multiparas, 195/2446 (8.0%) were transferred, 118 (4.8%) during labor and 77 (3.2%) after birth. The most common indication for transfers during labor was slow progress. In transfers after birth, postpartum hemorrhage, tears and neonatal respiratory problems were the most common indications. A total of 116 of the 3068 women had transfers classified as potentially urgent.CONCLUSIONS: One-third of all nulliparous and 8.0% of multiparous women were transferred during labor or within 72 h of the birth. The proportion of potentially urgent transfers was 3.8%.",

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author = "Ellen Blix and Kumle, {Merethe H} and Karen Ingversen and Huitfeldt, {Anette S} and Hegaard, {Hanne K} and {\'O}lafsd{\'o}ttir, {{\'O}l{\"o}f {\'A}} and P{\aa}l {\O}ian and Helena Lindgren",

note = "{\textcopyright} 2016 Nordic Federation of Societies of Obstetrics and Gynecology.",

year = "2016",

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TY - JOUR

T1 - Transfers to hospital in planned home birth in four Nordic countries

T2 - a prospective cohort study

AU - Blix, Ellen

AU - Kumle, Merethe H

AU - Ingversen, Karen

AU - Huitfeldt, Anette S

AU - Hegaard, Hanne K

AU - Ólafsdóttir, Ólöf Á

AU - Øian, Pål

AU - Lindgren, Helena

PY - 2016/4/1

Y1 - 2016/4/1

N2 - INTRODUCTION: Women planning a home birth are transferred to hospital in case of complications or elevated risk for adverse outcomes. The aim of the present study was to describe the indications for transfer to hospital in planned home births, and the proportion of cases in which this occurs.MATERIAL AND METHODS: Women in Norway, Sweden, Denmark and Iceland who had opted for, and were accepted for, home birth at the onset of labor, were included in the study. Data from 3068 women, 572 nulliparas and 2446 multiparas, were analyzed for proportion of transfers during labor and within 72 h after birth, indications for transfer, how long before or after birth the transfer started, time from birth to start of transfer, duration and mode of transfer, and whether the transfer was classified as potentially urgent. Analyses were stratified for nulliparity and multiparity.RESULTS: One-third (186/572) of the nulliparas were transferred to hospital, 137 (24.0%) during labor and 49 (8.6%) after the birth. Of the multiparas, 195/2446 (8.0%) were transferred, 118 (4.8%) during labor and 77 (3.2%) after birth. The most common indication for transfers during labor was slow progress. In transfers after birth, postpartum hemorrhage, tears and neonatal respiratory problems were the most common indications. A total of 116 of the 3068 women had transfers classified as potentially urgent.CONCLUSIONS: One-third of all nulliparous and 8.0% of multiparous women were transferred during labor or within 72 h of the birth. The proportion of potentially urgent transfers was 3.8%.

AB - INTRODUCTION: Women planning a home birth are transferred to hospital in case of complications or elevated risk for adverse outcomes. The aim of the present study was to describe the indications for transfer to hospital in planned home births, and the proportion of cases in which this occurs.MATERIAL AND METHODS: Women in Norway, Sweden, Denmark and Iceland who had opted for, and were accepted for, home birth at the onset of labor, were included in the study. Data from 3068 women, 572 nulliparas and 2446 multiparas, were analyzed for proportion of transfers during labor and within 72 h after birth, indications for transfer, how long before or after birth the transfer started, time from birth to start of transfer, duration and mode of transfer, and whether the transfer was classified as potentially urgent. Analyses were stratified for nulliparity and multiparity.RESULTS: One-third (186/572) of the nulliparas were transferred to hospital, 137 (24.0%) during labor and 49 (8.6%) after the birth. Of the multiparas, 195/2446 (8.0%) were transferred, 118 (4.8%) during labor and 77 (3.2%) after birth. The most common indication for transfers during labor was slow progress. In transfers after birth, postpartum hemorrhage, tears and neonatal respiratory problems were the most common indications. A total of 116 of the 3068 women had transfers classified as potentially urgent.CONCLUSIONS: One-third of all nulliparous and 8.0% of multiparous women were transferred during labor or within 72 h of the birth. The proportion of potentially urgent transfers was 3.8%.

KW - Adult

KW - Female

KW - Home Childbirth

KW - Hospitalization

KW - Humans

KW - Obstetric Labor Complications

KW - Patient Transfer

KW - Pregnancy

KW - Pregnancy Outcome

KW - Prospective Studies

KW - Registries

KW - Risk

KW - Scandinavian and Nordic Countries

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1111/aogs.12858

DO - 10.1111/aogs.12858

M3 - Journal article

C2 - 26830511

SN - 0001-6349

VL - 95

SP - 420

EP - 428

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

IS - 4

ER -

Transfers to hospital in planned home birth in four Nordic countries: a prospective cohort study

Abstract

Keywords

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