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The Birthplace in England national prospective cohort study: further analyses to enhance policy and service delivery decision-making for planned place of birth |
Hollowell J, Rowe R, Townend J, Knight M, Li Y, Linsell L, Redshaw M, Brocklehurst P, Macfarlane A, Marlow N, McCourt C, Newburn M, Sandall J, Silvert |
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Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Hollowell J, Rowe R, Townend J, Knight M, Li Y, Linsell L, Redshaw M, Brocklehurst P, Macfarlane A, Marlow N, McCourt C, Newburn M, Sandall J, Silvert. The Birthplace in England national prospective cohort study: further analyses to enhance policy and service delivery decision-making for planned place of birth. Health Services and Delivery Research 2015; 3(36) Authors' objectives This project aimed to provide further evidence to support the development and delivery of maternity services and inform women's choice of birth setting: specifically, to explore maternal and organisational factors associated with intervention, transfer and other outcomes in each birth setting in 'low risk' and 'higher risk' women. Authors' conclusions Expansion in the capacity of non-OU intrapartum care could reduce intervention rates in 'low risk' women, and the benefits of midwifery-led intrapartum care apply to all 'low risk' women irrespective of age, ethnicity or area deprivation score. Intervention rates differ considerably between units, however, for reasons that are not understood. The impact of major changes in the configuration of maternity care on outcomes should be monitored and evaluated. The impact of non-clinical factors, including labour ward practices, staffing and skill mix and women's preferences and expectations, on intervention requires further investigation. All women planning non-OU birth should be informed of their chances of transfer and, in particular, older nulliparous women and those more than 1 week past their due date should be advised of their increased chances of transfer. No change in the guidance on planning place of birth for 'higher risk' women is recommended, but research is required to evaluate the safety of planned AMU birth for women with selected relatively common risk factors. Indexing Status Subject indexing assigned by CRD MeSH Birthing Centers; Cohort Studies; Decision Making; Delivery Rooms; Delivery, Obstetric; England; Female; Home Childbirth; Humans; Midwifery; Patient Care Planning; Perinatal Care; Policy; Pregnancy Language Published English Country of organisation England English summary An English language summary is available. Address for correspondence HS&DR Programme, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, University of Southampton, Alpha House, Enterprise Road, Southampton, SO16 7NS, UK Tel: +44 23 8059 4304
Email: hsdrinfo@southampton.ac.uk AccessionNumber 32015000970 Date abstract record published 02/09/2015 |
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