Volume 199 - Issue 11
Publicly funded homebirth in Australia: a review of maternal and neonatal outcomes over 6 years
Authors: Christine Catling-Paull, Rebecca L Coddington, Maralyn J Foureur and Caroline S E Homer
Med J Aust 2013; 199 (11): 743. || doi: 10.5694/mja13.11003
Published online: 16 December 2013
Published online: 16 December 2013
In reply: We agree that our retrospective review1 did not provide all the details about neonatal morbidity and mortality. There were limited data available on the reasons for hospital transfer and neonatal death. We explained these limitations in the article and have hence embarked on a wider study of birthplace in Australia.2
It was interesting to us that even in this low-risk population, there were 10 breech ...
In reply: We agree that our retrospective review1 did not provide all the details about neonatal morbidity and mortality. There were limited data available on the reasons for hospital transfer and neonatal death. We explained these limitations in the article and have hence embarked on a wider study of birthplace in Australia.2
It was interesting to us that even in this low-risk population, there were 10 breech births. We do not believe that planned breech birth should occur at home.
It is always difficult to compare perinatal mortality rates, as data from one state are not always comparable with data across a number of states. It is important to reinforce that this was a study of publicly-funded homebirth; we did not include homebirth facilitated by independent midwives as the WA review did.3 Our study found a stillbirth and early neonatal death rate of 1.7 per 1000 births. Despite our study not being powered for safety, these figures are encouraging, but more research is needed.
Competing interests
No relevant disclosures.
References
- Catling-Paull C, Coddington RL, Foureur MJ, Homer CSE; the Birthplace in Australia Study and the National Publicly-funded Homebirth. Publicly funded homebirth in Australia: a review of maternal and neonatal outcomes over 6 years. Med J Aust 2013; 198: 616-620.
- Centre for Midwifery, Child and Family Health. Birthplace in Australia. Sydney: University of Technology, Sydney, 2013. http://www.nmh. uts.edu.au/cmcfh/research/birthplace.html (accessed Jul 2013).
- Newnham J (Chair). 13th report of the Perinatal and Infant Mortality Committee of Western Australia for deaths in the triennium 2005–07. (Report No. HP10489 Jan 11.) Perth: Department of Health WA, 2010. http://www.health.wa.gov. au/publications/documents/perinatal/13th_report_perinatal_infant_mortality_2005-7.pdf (accessed Nov 2013).