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CMAJ • June 11, 2002; 166 (12)
© 2002 Canadian Medical Association or its licensors

Letters
Correspondance

The pleasures of home birth?

Liz Okon* and M. A. Okon{dagger}

*Registered Nurse, Registered Midwife Clarenville, Nfld.; {dagger}Physician Clarenville, Nfld.

This study1 contained significant biases. The groups were not like for like2,3,4,5 because members of the hospital specialist group were shorter, more likely to have had a previous cesarean section, weighed more and were less likely to be multiparous. Hence, they were more prone to dystocia than members of the home-birth group.

As well, comparisons were made for induction of labour and epidural/spinal analgesia, but these interventions are usually unavailable during home births.3 Are the authors implying that they are available at home in British Columbia? The overall transfer rate of about 22% was high. What were the major indications for transfer prepartum and intrapartum?

This article is too biased to allow us to draw any meaningful comparisons between home and hospital births. Moreover, the conclusions are not justified by the evidence presented.6 The first step would be to compare like for like — a randomized selection of appropriate patients for home or hospital birth.1,2,3,4

Liz Okon Registered Nurse, Registered Midwife Clarenville, Nfld. M. A. Okon Physician Clarenville, Nfld.

References

  1. Janssen PA, Lee SK, Ryan EM, Etches DJ, Farquharson DF, Peacock D, et al. Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia. CMAJ 2002;166(3):315-23.[Abstract/Free Full Text]
  2. Ackermann-Liebrich U, Voegeli T, Gunter-Witt K, Kunz I, Zullig M, Schindler C, et al. Home versus hospital deliveries: follow up study of matched pairs for procedures and outcome. BMJ 1996;313(7068):1313-8.[Abstract/Free Full Text]
  3. Chamberlain G, Wraight A, Crowley P. Birth at home. Pract Midwife Jul-Aug;2(7):35-9.
  4. Wiegers TA, Keirse MJ, van der Zee J, Berghs GA. Outcome of planned home and hospital births in low risk pregnancies: prospective study in midwifery practices in The Netherlands. BMJ 1996; 313: 1309-13.[Abstract/Free Full Text]
  5. Woodcock HC, Rad AW, Bower C, Stanley FJ, Moore DJ. A matched cohort study of planned home and hospital births in Western Australia 1981-1987. Midwifery 1994;10:125-35.[Medline]
  6. Olsen O, Jewell MD. Home versus hospital birth [Cochrane Review]. In: The Cochrane Library; 2000. Oxford: Update Software.




This Article
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