Home or Home-like Hospital Birth

NCT00237601 | Completed

• 1 other identifier: PF 198
• Study Type: observational
• Target: 500
• Locations: 1 country
• Sites: 1

Brief Summary

In the Netherlands, which has about 200.000 births per year, maternity care is provided by midwives or general practitioners unless medical reasons necessitate specialist obstetric care. Women with low risk pregnancies are free to decide where to give birth, attended by their midwife or general practitioner, at home or in the hospital, from which they are then discharged within 24 hours. In the Netherlands these hospital births are referred to as "poliklinische bevallingen" (i.e. outpatient deliveries) to indicate that they do not involve formal hospitalisation, or as "verplaatste thuisbevalling" (i.e. relocated home births) to indicate that they are supervised by the same caregivers as the home births without involvement of specialist obstetricians. In the last two decades a marked increase in the referral rate to obstetricians during childbirth has occurred, especially for nulliparae, both in planned home births and planned hospital births (outpatient deliveries). 90% from all primigravidae will start their pregnancy under care of the primary caregiver (midwife of general practitioner). During the pregnancy 30% will be referred to the secondary caregiver (obstetrician specialist). The other 60% will start labor guided by the primary caregiver. More than 50% of these women will be referred to the obstetrician during labor. Despite this unique situation of the Dutch maternity care, the differences between home and hospital birth (outpatient deliveries) with regard to effectivity and efficiency have never been investigated. It is also unclear if pregnant women are informed about a 50% risk of being transported to the secondary caregiver/ hospital during labor at home. Neither do we know what their experiences are. This study aims to investigate the differences between home and hospital deliveries under care of the primary caregiver with regard to effectivity (costs) and efficiency (patient satisfaction) of care.

Conditions

Pregnancy

Keywords

Home birth; Hospital birth; Midwifery; Effectivity; Efficiency

Outcome Measures

Primary Outcomes (1)

• primary outcome: referral rate to secondary care, preferences of women and partners with regard to place of birth. Secondary outcome: costs of home birth and hospital births satisfaction of obstetric care

Study Arms (2)

1

Women with the intention to give birth at home

Other: obstetric care

2

Women with the intention to give birth in a short-stay hospital setting

Other: obstetric care

Interventions

obstetric care OTHER

1; 2

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Women with a low-risk pregnancy under the care of an independent midwife. Women are free to choose where to give birth, at home or in a short-stay hospital setting. The women are fluent in de Dutch language.

You may qualify if:

• Primiparae
• No medical indication for specialistic care
• The pregnant woman will be able to give birth at home or at a hospital
• The woman and her partner will be fluent in the Dutch language

Sponsors & Collaborators

• Maastricht University Medical Center: lead
• School for Midwifery Maastricht: collaborator

Study Sites (1)

Academic Hospital Maastricht

Maastricht, 6202 HX, Netherlands

Location

Related Publications (1)

• Aldana-Bitar J, Moore J, Manubolu VS, Dahal S, Verghese D, Lakshmanan S, Hussein L, Crabtree T, Jonas R, Min JK, Earls JP, Budoff MJ. Plaque Progression Differences Between Apixaban and Rivaroxaban in Patients With Atrial Fibrillation Measured With Cardiac Computed Tomography and Plaque Quantification. Am J Ther. 2023 Jul-Aug 01;30(4):e313-e320. doi: 10.1097/MJT.0000000000001569. Epub 2022 Oct 18.

  PMID: 36731003 DERIVED

Study Officials

• Jan G. Nijhuis, Prof dr MD PhD

  Maastricht University Medical Center

  STUDY CHAIR

• Marijke JC Hendrix, MBA

  Maastricht University Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: October 7, 2005
• First Posted: October 12, 2005
• Study Start: January 1, 2006
• Primary Completion: March 1, 2008
• Study Completion: December 1, 2008
• Last Updated: April 2, 2010

Record last verified: 2010-04

Locations

NL (1)