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• W2157142414 abstract "Objective To compare vaginal birth rates in women planning vaginal birth after caesarean ( VBAC ) at home versus in an obstetric unit ( OU ) and explore transfer rates in women planning home VBAC . Design Prospective cohort study. Setting OU s and planned home births in England. Population 1436 women planning VBAC in the Birthplace cohort, including 209 planning home VBAC . Methods We used Poisson regression to calculate relative risks adjusted for maternal characteristics. Main outcome measures Main outcomes: (i) vaginal birth and (ii) transfer from planned home birth to OU during labour or immediately after birth. Secondary outcomes: (i) composite of maternal blood transfusion or admission to higher level care, (ii) stillbirth or Apgar score <7 at 5 minutes, (iii) neonatal unit admission. Results Planned VBAC at home was associated with a statistically significant increase in the chances of having a vaginal birth compared with planned VBAC in an OU (adjusted relative risk 1.15, 95% confidence interval 1.06–1.24). The risk of an adverse maternal outcome was around 2–3% in both settings, with a similar risk of an adverse neonatal outcome. Transfer rates were high (37%) and varied markedly by parity (para 1, 56.7% versus para 2+, 24.6%). Conclusion Women in the cohort who planned VBAC at home had an increased chance of a vaginal birth compared with those planning VBAC in an OU , but transfer rates were high, particularly for women with only one previous birth, and the risk of an adverse maternal or perinatal outcome was around 2–3%. No change in guidance can be recommended. Tweetable abstract Higher vaginal birth rates in planned VBAC at home versus in OU but 2–3% adverse outcomes and high transfer rate." @default.
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• W2157142414 date "2015-07-23" @default.
• W2157142414 modified "2023-10-18" @default.
• W2157142414 title "Maternal and perinatal outcomes in women planning vaginal birth after caesarean ( <scp>VBAC</scp> ) at home in England: secondary analysis of the Birthplace national prospective cohort study" @default.
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• W2157142414 doi "https://doi.org/10.1111/1471-0528.13546" @default.
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