Planned homebirths in Western Australia 1981-1987: a descriptive study

Descriptive data on all 995 singleton planned homebirths in Western Australia from 1981 to 1987, including transfers to hospital, were collected from homebirth records and other sources. Data on singleton Caucasian births in Western Australia for the same years are also presented. The proportion of homebirths rose from 3.5 per 1000 to 7.9 per 1000 singleton births over the study period. Women who had planned homebirths were predominantly Caucasian, similar in parity and marital status but taller and slightly older. They were not all at low risk as some had had complications in previous pregnancies. Transfers to hospital (antenatal, intrapartum or postpartum) occurred in 24.6% of planned homebirths, about 20% in each year transferring before delivery. The main reason for transfer was failure to progress in labour. Postpartum haemorrhage occurred in 8.5% of women, 1.9% of infants were of low birthweight and 3.2% were born before term. The perinatal mortality proportion was 10.1 per 1000 total births. Based on the results of this study homebirth practice in Western Australia appears to be characterised by appropriate diagnosis and referral of complications. As randomised controlled trials of planned home and hospital births are not possible, data such as these are important in evaluating homebirth practice and assisting in the formulation of policy.