Maternal outcomes by planned place of birth
| Outcome | Freestanding n=494 N (%) | Tertiary n=3157 N (%) | Unadjusted OR (95% CI)* | Adjusted OR (95% CI)*† | p Value* |
|---|---|---|---|---|---|
| Mode of birth | |||||
| Spontaneous vaginal | 400 (81.0) | 2044 (64.7) | 2.32 (1.83 to 2.93) | 1.57 (1.20 to 2.06)‡ | 0.001 |
| Instrumental | 34 (6.9) | 331 (10.5) | 0.63 (0.44 to 0.91) | 0.79 (0.53 to 1.17)‡ | 0.237 |
| Caesarean section | 60 (12.1) | 782 (24.8) | 0.42 (0.32 to 0.56) | 0.65 (0.48 to 0.88)‡ | 0.006 |
| Intrapartum | 40 (8.1) | 413 (13.1) | 0.53 (0.38 to 0.74) | 0.76 (0.53 to 1.10)‡ | 0.151 |
| Elective | 20 (4.0) | 369 (11.7) | 0.32 (0.20 to 0.51) | 0.50 (0.29 to 0.88)‡ | 0.02 |
| Labour onset§ | |||||
| Spontaneous | 378 (76.5) | 1782 (56.4) | 2.51 (2.02 to 3.13) | 2.01 (1.60 to 2.54) | <0.0001 |
| Induction | 97 (19.6) | 1010 (32.0) | 0.52 (0.41 to 0.66) | 0.50 (0.39 to 0.63) | <0.0001 |
| Labour intervention | |||||
| Augmentation | 66 (13.4) | 690 (21.9) | 0.55 (0.42 to 0.72) | 0.51 (0.38 to 0.67) | <0.0001 |
| Analgesia | |||||
| Epidural/spinal | 62 (12.6) | 577 (18.3) | 0.64 (0.48 to 0.85) | 0.87 (0.63 to 1.19)¶ | 0.388 |
| Intramuscular/ intravenous narcotic | 38 (7.7) | 856 (27.1) | 0.22 (0.16 to 0.31) | 0.26 (0.18 to 0.36)¶ | <0.0001 |
| No analgesia | 115 (23.3) | 556 (17.6) | 1.42 (1.13 to 1.78) | 0.92 (0.72 to 1.18)¶ | 0.512 |
| Blood loss (mL) | |||||
| <500 | 428 (86.6) | 2533 (80.2) | 1.60 (1.22 to 2.10) | 1.37 (1.03 to 1.82)‡ | 0.029 |
| 500–999 | 48 (9.7) | 485 (15.4) | 0.59 (0.43 to 0.81) | 0.70 (0.51 to 0.97)‡ | 0.031 |
| >1000 | 18 (3.6) | 139 (4.4) | 0.82 (0.50 to 1.35) | 0.88 (0.52 to 1.47)‡ | 0.618 |
| Third stage | |||||
| Physiological | 185 (37.4) | 93 (2.9) | 19.7 (15.0 to 26.0) | 15.03 (11.05 to 20.43)‡ | <0.0001 |
| Perineal trauma | |||||
| None/graze | 241 (48.8) | 1752 (55.5) | 0.76 (0.63 to 0.92) | 0.88 (0.71 to 1.10)** | 0.275 |
| 1st/2nd degree tear | 229 (46.4) | 1273 (40.3) | 1.28 (1.06 to 1.55) | 1.15 (0.93 to 1.42)** | 0.210 |
| 3rd/4th degree tear | 24 (4.9) | 132 (4.2) | 1.17 (0.75 to 1.83) | 0.90 (0.56 to 1.45)** | 0.671 |
| Episiotomy | |||||
| Episiotomy | 38 (7.7) | 315 (10.0) | 0.75 (0.53 to 1.07) | 0.81 (0.55 to 1.19)** | 0.275 |
| Extended to 3rd/4th | 7 (1.4) | 37 (1.2) | 1.2 (0.53 to 2.71) | 1.59 (0.67 to 3.77)** | 0.292 |
*Statistically significant results in bold. p Values reported for adjusted ORs.
†All adjusted ORs adjusted for maternal age, smoking status, parity, risk at the onset of labour, previous caesarean section and gestation at the time of birth.
‡Also adjusted for augmentation and induction.
§One woman from the freestanding midwifery unit group and four women from the tertiary level maternity unit group went into labour spontaneously and proceeded to have an elective caesarean section. They were coded as spontaneous and elective caesarean.
¶Also adjusted for augmentation and induction. Elective caesarean sections excluded from analysis.
**Also adjusted for augmentation and induction. All caesarean sections excluded from analysis.