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Re-Investigating Outcomes of Hospital and Community Births in Washington State.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Re-Investigating Outcomes of Hospital and Community Births in Washington State./
Author:	Muhajir, Mana.
other author:	Schmauder, Ronan,
Description:	1 online resource (26 pages)
Notes:	Source: Masters Abstracts International, Volume: 84-01.
Contained By:	Masters Abstracts International84-01.
Subject:	Obstetrics. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=29256294click for full text (PQDT)
ISBN:	9798834068532

Re-Investigating Outcomes of Hospital and Community Births in Washington State.
Muhajir, Mana.

Re-Investigating Outcomes of Hospital and Community Births in Washington State. - 1 online resource (26 pages)

Source: Masters Abstracts International, Volume: 84-01.

Thesis (M.S.M.W.)--Bastyr University, 2022.

Includes bibliographical references

Rates of planned home birth in the US fall below many comparative countries; this is in large part due to the perception of risk fueled by the American College of Obstetricians and Gynecologists (ACOG) Committee Opinion on Planned Home Birth (ACOG, 2020). This Committee Opinion has been largely informed by a study conducted in Washington State evaluating the safety of planned home birth in comparison to hospital births (Pang et al., 2002). The authors used birth certificate data from 1989 to 1996 to assess outcomes, including obstetrical interventions, parental and newborn complications, as well as mortality rates. They reported that the planned home birth cohort had greater infant and birthing person risks than the hospital birth group. A critical review of the Pang study yields notable flaws that impact the accuracy and validity of the study findings. As these findings have informed the conversation in the United States about birth at home and impacted perceptions and policies, it is imperative to take a closer look at the study's design and analytical methods. The purpose of this project was to provide an updated analysis without the methodological flaws shown in the Pang study to more accurately evaluate the outcomes of community birth. This updated study will be an important addition to the growing body of research showing the safety of community birth. We found that the analysis and results of Washington birth certificate data for low-risk births suggest that community birth is a safe option for birthing people and newborns.Our analysis found multiple design and analytical flaws which will be discussed in this paper. These include the inclusion of preterm deliveries occurring at home and may have erroneously contributed to the increased risk that the authors found and impacted their conclusions regarding the safety of home birth. Additionally, in the hospital comparison group, birth certificates were selected at random, with no indication of methodology and inclusion/exclusion criteria, and were then included in the study (Pang et al., 2002). Despite the Pang study, other studies have found different conclusions around safety. Since the Pang study was published, there have been many studies conducted around world that addresses the safety of home birth, such as Cheyney et al. (2014), Janssen et al. (2009), and Olsen & Clausen (2012) which will be discussed in more detail later in this paper. In summary, these three rigorous studies concluded no significant differences between planned community and planned hospital births and advocated for further integration of midwives into the healthcare system in the United States (Janssen et al., 2009; Olsen & Clausen, 2012). While Cheyney et al. did not have a hospital comparison group, the authors also advocated for further integration of midwives into the healthcare system as they deemed community birth a safe alternative for low-risk singleton pregnancies (Cheyney et al., 2014).

Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2023

Mode of access: World Wide Web

ISBN: 9798834068532Subjects--Topical Terms:

634501
Obstetrics.
Subjects--Index Terms:

Birth certificateIndex Terms--Genre/Form:

542853
Electronic books.

Re-Investigating Outcomes of Hospital and Community Births in Washington State.
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500 $a Source: Masters Abstracts International, Volume: 84-01.
500 $a Advisor: Taiwo, Tanya.
502 $a Thesis (M.S.M.W.)--Bastyr University, 2022.
504 $a Includes bibliographical references
520 $a Rates of planned home birth in the US fall below many comparative countries; this is in large part due to the perception of risk fueled by the American College of Obstetricians and Gynecologists (ACOG) Committee Opinion on Planned Home Birth (ACOG, 2020). This Committee Opinion has been largely informed by a study conducted in Washington State evaluating the safety of planned home birth in comparison to hospital births (Pang et al., 2002). The authors used birth certificate data from 1989 to 1996 to assess outcomes, including obstetrical interventions, parental and newborn complications, as well as mortality rates. They reported that the planned home birth cohort had greater infant and birthing person risks than the hospital birth group. A critical review of the Pang study yields notable flaws that impact the accuracy and validity of the study findings. As these findings have informed the conversation in the United States about birth at home and impacted perceptions and policies, it is imperative to take a closer look at the study's design and analytical methods. The purpose of this project was to provide an updated analysis without the methodological flaws shown in the Pang study to more accurately evaluate the outcomes of community birth. This updated study will be an important addition to the growing body of research showing the safety of community birth. We found that the analysis and results of Washington birth certificate data for low-risk births suggest that community birth is a safe option for birthing people and newborns.Our analysis found multiple design and analytical flaws which will be discussed in this paper. These include the inclusion of preterm deliveries occurring at home and may have erroneously contributed to the increased risk that the authors found and impacted their conclusions regarding the safety of home birth. Additionally, in the hospital comparison group, birth certificates were selected at random, with no indication of methodology and inclusion/exclusion criteria, and were then included in the study (Pang et al., 2002). Despite the Pang study, other studies have found different conclusions around safety. Since the Pang study was published, there have been many studies conducted around world that addresses the safety of home birth, such as Cheyney et al. (2014), Janssen et al. (2009), and Olsen & Clausen (2012) which will be discussed in more detail later in this paper. In summary, these three rigorous studies concluded no significant differences between planned community and planned hospital births and advocated for further integration of midwives into the healthcare system in the United States (Janssen et al., 2009; Olsen & Clausen, 2012). While Cheyney et al. did not have a hospital comparison group, the authors also advocated for further integration of midwives into the healthcare system as they deemed community birth a safe alternative for low-risk singleton pregnancies (Cheyney et al., 2014).
533 $a Electronic reproduction. $b Ann Arbor, Mich. : $c ProQuest, $d 2023
538 $a Mode of access: World Wide Web
650 4 $a Obstetrics. $3 634501
650 4 $a Medicine. $3 641104
653 $a Birth certificate
653 $a Community births
653 $a Hospital
653 $a Midwives
653 $a Outcomes
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700 1 $a Schmauder, Ronan, $e author. $3 3697414
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710 2 $a Bastyr University. $b Department of Midwifery. $3 3191233
773 0 $t Masters Abstracts International $g 84-01.
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