Home or Home-like Hospital Birth

This study has been completed.
Sponsor:
Collaborator:
School for Midwifery Maastricht
Information provided by:
Maastricht University Medical Center
ClinicalTrials.gov Identifier:
NCT00237601
First received: October 7, 2005
Last updated: April 1, 2010
Last verified: April 2010
  Purpose

In the Netherlands, which has about 200.000 births per year, maternity care is provided by midwives or general practitioners unless medical reasons necessitate specialist obstetric care. Women with low risk pregnancies are free to decide where to give birth, attended by their midwife or general practitioner, at home or in the hospital, from which they are then discharged within 24 hours. In the Netherlands these hospital births are referred to as "poliklinische bevallingen" (i.e. outpatient deliveries) to indicate that they do not involve formal hospitalisation, or as "verplaatste thuisbevalling" (i.e. relocated home births) to indicate that they are supervised by the same caregivers as the home births without involvement of specialist obstetricians.

In the last two decades a marked increase in the referral rate to obstetricians during childbirth has occurred, especially for nulliparae, both in planned home births and planned hospital births (outpatient deliveries). 90% from all primigravidae will start their pregnancy under care of the primary caregiver (midwife of general practitioner). During the pregnancy 30% will be referred to the secondary caregiver (obstetrician specialist). The other 60% will start labor guided by the primary caregiver. More than 50% of these women will be referred to the obstetrician during labor.

Despite this unique situation of the Dutch maternity care, the differences between home and hospital birth (outpatient deliveries) with regard to effectivity and efficiency have never been investigated. It is also unclear if pregnant women are informed about a 50% risk of being transported to the secondary caregiver/ hospital during labor at home. Neither do we know what their experiences are.

This study aims to investigate the differences between home and hospital deliveries under care of the primary caregiver with regard to effectivity (costs) and efficiency (patient satisfaction) of care.


Condition Intervention Phase
Pregnancy
Other: obstetric care
Phase 3

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: Home or Home-like Hospital Birth for Low-risk Nulliparae: Does it Matter?

Resource links provided by NLM:


Further study details as provided by Maastricht University Medical Center:

Primary Outcome Measures:
  • primary outcome: referral rate to secondary care, preferences of women and partners with regard to place of birth. Secondary outcome: costs of home birth and hospital births satisfaction of obstetric care [ Designated as safety issue: No ]

Enrollment: 500
Study Start Date: January 2006
Study Completion Date: December 2008
Primary Completion Date: March 2008 (Final data collection date for primary outcome measure)
Groups/Cohorts Assigned Interventions
1
Women with the intention to give birth at home
Other: obstetric care
2
Women with the intention to give birth in a short-stay hospital setting
Other: obstetric care

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population

Women with a low-risk pregnancy under the care of an independent midwife. Women are free to choose where to give birth, at home or in a short-stay hospital setting. The women are fluent in de Dutch language.

Criteria

Inclusion Criteria:

  • Primiparae
  • No medical indication for specialistic care
  • The pregnant woman will be able to give birth at home or at a hospital
  • The woman and her partner will be fluent in the Dutch language
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00237601

Locations
Netherlands
Academic Hospital Maastricht
Maastricht, Netherlands, 6202 HX
Sponsors and Collaborators
Maastricht University Medical Center
School for Midwifery Maastricht
Investigators
Study Chair: Jan G. Nijhuis, Prof dr MD PhD Maastricht University Medical Center
Principal Investigator: Marijke JC Hendrix, MBA Maastricht University Medical Center
  More Information

No publications provided

Responsible Party: Jan G. Nijhuis, Prof MD PhD, Maastricht University Medical Centre
ClinicalTrials.gov Identifier: NCT00237601     History of Changes
Other Study ID Numbers: PF 198
Study First Received: October 7, 2005
Last Updated: April 1, 2010
Health Authority: Netherlands: Medical Ethics Review Committee (METC)

Keywords provided by Maastricht University Medical Center:
Home birth
Hospital birth
Midwifery
Effectivity
Efficiency

ClinicalTrials.gov processed this record on October 21, 2014