Tyson H
Birth. 1991 Mar;18(1):14-9. doi: 10.1111/j.1523-536x.1991.tb00047.x.
A retrospective descriptive study of 1001 midwife-attended home births in Toronto, Ontario, was carried out between January 1983 and July 1988. Interviews with 26 midwives and reviews of client records provided data on maternal age, socio-economic status, gestation, ruptured membranes, length of labor, episiotomies and perineal lacerations, transfer to hospital of mother or baby or both, infant resuscitation, and breastfeeding. Of 1001 planned home births, 361 involved primiparous women, of whom 245 (68%) remained at home and 116 (32%) required transfer of mother or baby to hospital during labor or the first four postpartum days. Of the 640 multiparous births, 591 (92%) women remained at home and 49 (8%) required transfer to hospital. Among women transferred, 91 had spontaneous vaginal births, 34 had forceps deliveries, and 35 had cesarean sections. Variables significantly associated with maternal transfer for both primiparas and multiparas were length of latent and active phases of the first stage of labor, length of the second stage of labor, and duration of ruptured membranes. Five neonates were transferred and two died, one each after birth at home and in hospital. There were no maternal deaths. The proportion of mothers breastfeeding without supplement at 28 days postpartum was 98.6 percent.
1983年1月至1988年7月，在安大略省多伦多市进行了一项对1001例由助产士接生的家庭分娩的回顾性描述性研究。对26名助产士进行访谈并查阅客户记录，获取了产妇年龄、社会经济状况、孕周、胎膜破裂、产程长度、会阴切开术和会阴裂伤、母婴转院情况、婴儿复苏以及母乳喂养等数据。在1001例计划在家分娩中，361例涉及初产妇，其中245例（68%）在家分娩，116例（32%）在分娩期间或产后头四天需要将母婴转院。在640例经产妇分娩中，591例（92%）在家分娩，49例（8%）需要转院。在转院的产妇中，91例自然阴道分娩，34例产钳助产，35例剖宫产。与初产妇和经产妇转院显著相关的变量是第一产程潜伏期和活跃期的长度、第二产程的长度以及胎膜破裂持续时间。5例新生儿转院，2例死亡，分别在家中和医院出生后各死亡1例。无孕产妇死亡。产后28天纯母乳喂养的母亲比例为98.6%。
