Transfers to hospital in planned home birth in four Nordic countries – A prospective cohort study

• Published in: Acta Obstetricia et Gynecologica Scandinavica
• Main Authors: Blix, Ellen, Kumle, Merethe, Ingversen, Karen, Huitfeldt, Anette, Hegaard, Hanne Kristine, Olafsdottir, Olof Asta, Lindgren, Helena
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2016
• Subjects: VDP::Medisinske Fag: 700; VDP::Medical disciplines: 700; Planned home birth; Transfer to hospital; Indications for transfers; Potentially urgent transfer; Midwifery; Norway; Huitfeldt; Iceland
• Online Access: https://hdl.handle.net/10037/8945; https://doi.org/10.1111/aogs.12858

This is the peer reviewed version of the following article: Blix E, Kumle MH, Ingversen K, Huitfeldt AS, Hegaard HK, Ólafsdóttir ÓÁ, et al. Transfers to hospital in planned home birth in four Nordic countries – a prospective cohort study. Acta Obstet Gynecol Scand 2016; 95:420–428., which has been published in final form at http://dx.doi.org/10.1111/aogs.12858 . This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. Introduction. Women planning for home birth are transferred to hospital in case of complications or elevated risk for adverse outcomes. The aim of the present study was to describe the indications for transfer to hospital in planned home births, and the proportion of cases in which this occurs. Material and methods. Women in Norway, Sweden, Denmark and Iceland who had opted for, and were accepted for, home birth at the onset of labor, were included in the study. Data from 3068 women, 572 nulliparas and 2446 multiparas, were analyzed for proportion of transfers during labor and within 72 hours after birth, indications for transfer, how long before or after birth the transfer starte d, time from birth to start of transfer, duration and mode of transfer, and whether the transfer was classified as potentially urgent. Analyses were stratified for nulli - and multiparity. Results. One third (186/572) of the nulliparas were transferred to hospital, 137 (24.0%) during labor and 49 (8.6%) after the birth. Of the multiparas, 195/2446 (8.0%) were transferred, 118 (4.8%) during labor and 77 (3.2%) after birth. The most common indication for transfers during labor was slow progress. In transfers after birth, postpartum hemorrhage, tears and neonatal respiratory problems were the most common indications. A total of 116 of the 3068 women had transfers classified as potentially urgent. Conclusions. One third of all nulliparous and 8.0% of multiparous women were transferred during labor or within 72 hours of the birth. The proportion of potentially urgent transfers was 3.8%.