Planned Birthing Outcomes: A Meta-Analysis
Lindsey Harper
Mentor: Dr. Paige Muellerleile
Marshall SURE!
Home v. Hospital Birth: According to
Wax et al.

Planned home birth
↓ medical interventions
 ↓ infections
 ↓ hemorrhages
 ↓ retained placentas



Perinatal mortality was similar in both planned locations
The neonatal mortality rates are 3 times higher in
planned home birth, than planned hospital birthnonanomalous causes
Home v. Hospital Birth: According to
Wax et al.

Perinatal mortality
 “stillbirth
of at least 20 weeks or 500 g or death of live
born within 28 days of birth”
 similar in both planned locations

Neonatal mortality
 “death
of a live born within 28 days of delivery”
 rates are 3x higher in planned home birth than planned
hospital birth
Moderating Factors
The year of study – studies range from 1978-2012
Country: homebirth is more common in the
Netherlands, but accounts for fewer than 1% in U.S.
Mean age: We have studies ranging from
< 19 and > 40
Environmental Setting – e.g., rural, urban, metropolitan
1.
2.
3.
4.
1.
This is more of an access to resources moderator
Practitioner, one study specifically mentions licensed
midwives v. lay midwives.
5.
1.
Lay Midwives have 24 times the risk of infant mortality
Neonatal and Perinatal Definitions

Additional categories and definitions continue to be
listed, which means Dr. M and I will be creating
subcategories:
 Stillbirths
only (perinatal), if possible
 Early Neonatal (one day up until eight days old)
 Late Neonatal ( eight days old until 28 days)
Additional Studies and Collaboration
After comprehensive searches on Midwifery and AJOG:
35 Studies for possible inclusion, after further analysis,
23 definite inclusion.
We finally got an OB to agree to collaborate, though he’s
super biased against home birthing. We’re still waiting
on him to get back to us with his analysis of the Wax,
2010 meta-analysis.  This project is on hold until we
can talk to him.
In the Meantime. . .

Meta-analysis of fear and childbirth
 Well-being
of baby and potential complications of
women’s own health and well-being
 Biological process of giving birth (pain, labor process,
and possible medical interventions)
 Vaginal births are “dangerous”, “frightening”,
“unpredictable”
 Women are afraid that vaginal birth will create a loss
in “dignity.”
Meta-analysis on self-efficacy in childbirth was a flop due to few studies being published after 1990
Project SCRATCH



Sustainable Community Revitalization in
Appalachia Through Children’s Hands
Edited and submitted pieces for IRB renewal
application
On site interactions with the kids and garden
Put together consent packets
Sex Education Meta-analysis

Looking to see if comprehensive sex education or
abstinence only sex education causes an increase in
particular outcomes, such as:
Unplanned teenage pregnancies
 Use of contraceptives at last intercourse
 Use of contraceptives at first intercourse
 Knowledge or awareness of STI’s
 Contracting STI’s


Also seeing if we can relate it to Title IX,

Explain Barboursville Middle Sex Segregated Class
References




Chang, J., & Macones, G., (2011). Birth outcomes of planned home
births in Missouri: A population-based study. American Journal Of
Perinatology, 28(7), 529-536. doi:10.1055/s-0031-1272
Fenwick, J., Gamble, J., Creedy, D. K., & Bayes, S. (2010). Why do
women request caesarean section in a normal, healthy first
pregnancy?. Midwifery, 26(4), 394-400.
doi:10.1016/j.midw.2008.10.011
Fisher, C., Hauck, Y., & Fenwick, J. (2006). How social context
impacts on women’s fears of childbirth: a Western Australian
example. Social Science & Medicine, 63(1), 64-75.
MacDorman, M. F., Mathews, T. J., & Declerq, E. (2012). Home births
in the United States, 1990-2009. NCHS Data Brief, No. 84.
Hyattsville, MD: National Center for Health Statistics.