Frontier University, Tucson, Arizona (Dr Jolles); American Association of Birth Centers Research Committee, Perkiomenville, Pennsylvania (Drs Jolles, Niemcyzk, and Stapleton and Mss Sanders, Bauer, and Wright); Department of Nursing, Temple University College of Public Health, Philadelphia, Pennsylvania (Dr Montgomery); University of Maryland School of Nursing, Baltimore (Dr Blankstein Breman); Boston College Connell School of Nursing, Boston, Massachusetts (Ms George); University of Maryland College of Social Work, Baltimore (Dr Craddock); and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania (Ms Sanders and Dr Niemcyzk).
J Perinat Neonatal Nurs. 2022;36(2):150-160. doi: 10.1097/JPN.0000000000000647.
The purpose of this study was to describe sociodemographic variations in client preference for birthplace and relationships to perinatal health outcomes.
Descriptive data analysis (raw number, percentages, and means) showed that preference for birthplace varied across racial and ethnic categories as well as sociodemographic categories including educational status, body mass index, payer status, marital status, and gravidity. A subsample of medically low-risk childbearing people, qualified for birth center admission in labor, was analyzed to assess variations in maternal and newborn outcomes by site of first admission in labor.
While overall clinical outcomes exceeded national benchmarks across all places of admission in the sample, disparities were noted including higher cesarean birth rates among Black and Hispanic people. This variation was larger within the population of people who preferred to be admitted to the hospital in labor in the absence of medical indication.
This study supports that the birth center model provides safe delivery care across the intersections of US sociodemographics. Findings from this study highlight the importance of increased access and choice in place of birth for improving health equity, including decreasing cesarean birth and increasing breastfeeding initiation.
本研究旨在描述客户对分娩地点的偏好的社会人口学差异及其与围产期健康结果的关系。
描述性数据分析（原始数量、百分比和平均值）表明，在种族和族裔类别以及社会人口学类别（包括教育程度、体重指数、支付者状态、婚姻状况和孕次）中，对分娩地点的偏好存在差异。对有资格在分娩中心入院的医疗低风险生育人群进行了亚组分析，以评估在分娩时首次入院地点的产妇和新生儿结局的差异。
虽然在样本中所有入院地点的总体临床结局均超过了全国基准，但仍存在差异，包括黑人及西班牙裔人群的剖宫产率较高。在没有医疗指征而更愿意在医院分娩的人群中，这种差异更大。
本研究支持分娩中心模式在美国社会人口统计学中提供了安全的分娩护理。本研究的结果强调了增加获得和选择分娩地点的重要性，以改善健康公平，包括降低剖宫产率和增加母乳喂养的开始率。
