title: Outcomes of planned home births and planned hospital births in low-risk women in Norway between 1990 and 2007: a retrospective cohort study.
abstract: BACKGROUND
  The safety of planned home births remains controversial in Western countries. The aim of the present study was to compare outcomes in women who planned, and were selected to, home birth at the onset of labor with women who planned for a hospital birth.
  
  
  METHODS
  Data from 1631 planned home births between 1990 and 2007 were compared with a random sample of 16,310 low-risk women with planned hospital births. The primary outcomes were intrapartum intervention rates and complications. Secondary outcomes were perinatal and neonatal death rates.
  
  
  RESULTS
  Primiparas who planned home births had reduced risks for assisted vaginal delivery (OR 0.32; 95% CI 0.20-0.48), epidural analgesia (OR 0.21; CI 0.14-0.33) and dystocia (OR 0.40; CI 0.27-0.59). Multiparas who planned home births had reduced risks for operative vaginal delivery (OR 0.26; CI 0.12-0.56), epidural analgesia (OR 0.08; CI 0.04-0.16), episiotomy (OR 0.48; CI 0.31-0.75), anal sphincter tears (OR 0.29; CI 0.12-0.70), dystocia (OR 0.10; CI 0.06-0.17) and postpartum hemorrhage (OR 0.27; CI 0.17-0.41). We found no differences in cesarean section rate. Perinatal mortality rate was 0.6/1000 (CI 0-3.4) and neonatal mortality rate 0.6/1000 (CI 0-3.4) in the home birth cohort. In the hospital birth cohort, the rates were 0.6/1000 (CI 0.3-1.1) and 0.9/1000 (CI 0.5-1.5) respectively.
  
  
  CONCLUSIONS
  Planning for home births was associated with reduced risk of interventions and complications. The study is too small to make statistical comparisons of perinatal and neonatal mortality.
authors.affiliation: Clinical Research Department, University Hospital of North Norway, Tromsø, Norway. Ellen.Blix@unn.no
authors.forename: Ellen
authors.initials: E
authors.lastname: Blix
authors.forename: Anette Schaumburg
authors.initials: AS
authors.lastname: Huitfeldt
authors.forename: Pål
authors.initials: P
authors.lastname: Øian
authors.forename: Bjørn
authors.initials: B
authors.lastname: Straume
authors.forename: Merethe
authors.initials: M
authors.lastname: Kumle
mesh_terms: D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000401:mortality; D005260:Female; D006700:Home Childbirth / Q000401:mortality; D006761:Hospitals; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007743:Labor, Obstetric; D009664:Norway / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000401:mortality; D016017:Odds Ratio; D010298:Parity; D054238:Perinatal Mortality; D011247:Pregnancy; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors; D055815:Young Adult