Midwife-attended planned home births versus planned hospital births in Spain: Maternal and neonatal outcomes

Background The debate on the safety and outcomes of home versus hospital births highlights the need for evidence-based evaluations of these birthing settings, particularly in Catalonia where both options are available. Aim To compare sociodemographic characteristics and maternal and neonatal outcome...

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Detalles Bibliográficos
Autores: Alcaraz-Vidal, Lucia, Escuriet, Ramon, Palau-Costafreda, Roser, Leon-Larios, Fatima, Robleda, Gemma
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:20.500.14342/5138
Acceso en línea:http://hdl.handle.net/20.500.14342/5138
https://doi.org/10.1016/j.midw.2024.104101
Access Level:acceso abierto
Palabra clave:Part
Atenció domiciliària
Naixement
Obstetrícia
Neonatologia
Llevadores
Descripción
Sumario:Background The debate on the safety and outcomes of home versus hospital births highlights the need for evidence-based evaluations of these birthing settings, particularly in Catalonia where both options are available. Aim To compare sociodemographic characteristics and maternal and neonatal outcomes between low-risk women opting for home versus hospital births in Catalonia, Spain. Methods This observational cross-sectional study analysed 3,463 low-risk births between 2016 and 2018, including 2,713 hospital and 750 home births. Researchers collected sociodemographic data, birthing processes, and outcomes, using statistical analysis to explore differences between the settings. Findings Notable differences emerged: Women choosing home births typically had higher education levels and were predominantly Spanish. They were 3.43 times more likely to have a spontaneous birth and significantly less likely to undergo instrumental births than those in hospitals. Home births were associated with higher utilization of non-pharmacological analgesia and a more pronounced tendency to iniciate breastfeeding within the first hour post birth and stronger inclination towards breastfeeding. Hospital births, conversely, showed higher use of the lithotomy position and epidural analgesia. There were no significant differences in neonatal outcomes between the two groups. Conclusions and implication for practice Home births managed by midwives offered better obstetric and neonatal outcomes for low-risk women than hospital births. These results suggest home birth as a safe, viable option that promotes natural birthing processes and reduces medical interventions. The study supports the integration of midwife-led home birth into public health policies, affirming its benefits for maternal and neonatal health.