title: Publicly funded homebirth in Australia: a review of maternal and neonatal outcomes over 6 years.
abstract: OBJECTIVE
  To report maternal and neonatal outcomes for Australian women planning a publicly funded homebirth from 2005 to 2010.
  
  
  METHODS
  Retrospective analysis of data on women who planned a homebirth and on their babies. Data for 2005-2010 (or from the commencement of a program to 2010) were requested from the 12 publicly funded homebirth programs in place at the time.
  
  
  METHODS
  Maternal outcomes (mortality; place and mode of birth; perineal trauma; type of management of the third stage of labour; postpartum haemorrhage; transfer to hospital); and neonatal outcomes (early mortality; Apgar score at 5 minutes; birthweight; breastfeeding initially and at 6 weeks; significant morbidity; transfer to hospital; admission to a special care nursery).
  
  
  RESULTS
  Nine publicly funded homebirth programs in Australia provided data accounting for 97% of births in these programs during the period studied. Of the 1807 women who intended to give birth at home at the onset of labour, 1521 (84%) did so. 315 (17%) were transferred to hospital during labour or within one week of giving birth. The rate of stillbirth and early neonatal death was 3.3 per 1000 births; when deaths because of expected fetal anomalies were excluded it was 1.7 per 1000 births. The rate of normal vaginal birth was 90%.
  
  
  CONCLUSIONS
  This study provides the first national evaluation of a significant proportion of women choosing publicly funded homebirth in Australia; however, the sample size does not have sufficient power to draw a conclusion about safety. More research is warranted into the safety of alternative places of birth within Australia.
authors.affiliation: Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia. christine.catling-paull@uts.edu.au
authors.forename: Christine
authors.initials: C
authors.lastname: Catling-Paull
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Coddington
authors.forename: Maralyn J
authors.initials: MJ
authors.lastname: Foureur
authors.forename: Caroline S E
authors.initials: CS
authors.lastname: Homer
mesh_terms: D000328:Adult; D001034:Apgar Score; D001315:Australia / Q000453:epidemiology; D001724:Birth Weight; D005260:Female; D005380:Financing, Government / Q000706:statistics & numerical data*; D006700:Home Childbirth / Q000191:economics / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007744:Obstetric Labor Complications / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies