Search

To study perinatal mortality in women booked for birth centre care during pregnancy.Retrospective cohort study.In-hospital birth centre and standard maternity care in Stockholm.Two thousand and five hundred and thirty-four women (3256 pregnancies) admitted to an in-hospital birth centre over 10 years (1989–2000) and 126,818 women (180,380 pregnancies) who gave birth in standard care during the same period and who met the same medical inclusion criteria as in the birth centre. Multiple pregnancies were excluded.Data were collected from the Swedish Medical Birth Register. Information on all cases of perinatal death in the birth centre group was retrieved from the medical records.Perinatal mortality.No statistically significant difference in the overall perinatal mortality rate was observed between the birth centre group and the standard care group (odds ratio [OR] 1.5, 95% CI 0.9–2.4), but infants of primiparas were at greater risk (OR 2.2, 95% CI 1.3–3.9). Infants of multiparas tended to be at lower risk, but this difference was not statistically significant (OR 0.7, 95% CI 0.3–1.9). These figures were adjusted for maternal age and gestation in multiple regression analyses.Birth centre care may be less safe for infants of first-time mothers. [ABSTRACT FROM AUTHOR]

: ObjectiveTo investigate how many women wish to have a caesarean section when asked in early pregnancy, and to identify background variables associated with such a wish.: DesignNational survey.: SettingSwedish antenatal clinics.: Population3283 Swedish-speaking women booked for antenatal care, at approximately 600 Swedish antenatal clinics, during three weeks spread over one year (1999–2000).: MethodsA questionnaire was mailed shortly after the first antenatal visit.: Main outcome measuresWomen''s preferences for mode of delivery.: Results3061 women completed the first questionnaire, corresponding to 94% of those who consented to participate after exclusion of reported miscarriages. The background characteristics of the study sample were very similar to a one-year cohort of women giving birth in Sweden during 1999. The result showed that 8.2% of the women would prefer to have a caesarean section. A wish for caesarean section was associated with parity, age, civil status, residential area and obstetric history. Women preferring caesarean section were more depressed and worried, not only about giving birth, but also about other things in life. A multivariate logistic regression model showed three factors being statistically associated with a wish for caesarean section: a previous caesarean section, fear of giving birth and a previous negative birth experience.: ConclusionsRelatively few women wish to have a caesarean section when asked in early pregnancy, and these women seem to be a vulnerable group. [Copyright &y& Elsevier]