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Home-like versus conventional institutional settings for birth
E D Hodnett1, S Downe, N Edwards
1Faculty of Nursing, University of Toronto, 50 St. George Street, Toronto, Ontario, Canada, M5S 3H4. ellen.hodnett@utoronto.ca
The Cochrane Database of Systematic Reviews
|January 28, 2005
Summary
Home-like birth settings offer benefits like fewer interventions and higher satisfaction for mothers. However, vigilance for complications is crucial, as a trend towards increased perinatal mortality was observed.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Evidence-Based Childbirth
Background:
- Home-like birth settings are increasingly established for women desiring minimal medical intervention.
- These settings are located within or near conventional labor wards.
Purpose of the Study:
- To evaluate the impact of home-like birth environments versus conventional labor wards.
- To investigate if staffing, organization, or location influence these effects.
Main Methods:
- Systematic review of randomized and quasi-randomized controlled trials.
- Searched Cochrane Pregnancy and Childbirth Group trials register and handsearched journals.
- Six trials involving 8677 women were included.
Main Results:
- Home-like settings were linked to increased spontaneous vaginal births and maternal satisfaction.
- Reduced rates of intrapartum analgesia/anesthesia and episiotomies were observed.
- A trend towards higher perinatal mortality in home-like settings warrants attention.
Conclusions:
- Home-like birth settings provide modest benefits, including fewer interventions and greater maternal satisfaction.
- Caregivers and patients must remain alert to potential complications.
- Further research is needed on staffing and organizational models.