The Birthplace in England national prospective cohort study: further analyses to enhance policy and service delivery decision-making for planned place of birth

Hollowell J, Rowe R, Townend J, Knight M, Li Y, Linsell L, Redshaw M, Brocklehurst P, Macfarlane A, Marlow N, McCourt C, Newburn M, Sandall J, Silvert
Record ID 32015000970
Authors' objectives: This project aimed to provide further evidence to support the development and delivery of maternity services and inform women's choice of birth setting: specifically, to explore maternal and organisational factors associated with intervention, transfer and other outcomes in each birth setting in 'low risk' and 'higher risk' women.
Authors' recommendations: Expansion in the capacity of non-OU intrapartum care could reduce intervention rates in 'low risk' women, and the benefits of midwifery-led intrapartum care apply to all 'low risk' women irrespective of age, ethnicity or area deprivation score. Intervention rates differ considerably between units, however, for reasons that are not understood. The impact of major changes in the configuration of maternity care on outcomes should be monitored and evaluated. The impact of non-clinical factors, including labour ward practices, staffing and skill mix and women's preferences and expectations, on intervention requires further investigation. All women planning non-OU birth should be informed of their chances of transfer and, in particular, older nulliparous women and those more than 1 week past their due date should be advised of their increased chances of transfer. No change in the guidance on planning place of birth for 'higher risk' women is recommended, but research is required to evaluate the safety of planned AMU birth for women with selected relatively common risk factors.
Project Status: Completed
Year Published: 2015
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Humans
  • England
  • Delivery, Obstetric
  • Female
  • Pregnancy
  • Patient Care Planning
  • Home Childbirth
  • Birthing Centers
  • Delivery Rooms
  • Midwifery
  • Perinatal Care
  • Cohort Studies
  • Decision Making
  • Policy
Organisation Name: NIHR Health Services and Delivery Research programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
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Copyright: Queen's Printer and Controller of HMSO
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