TY - JOUR
T1 - Transfers Among Women Intending A Birth Center Delivery in the San Diego Birth Center Study
AU - Nguyen, Uyen-sa Duc tran
AU - Rothman, Kenneth J.
AU - Demissie, Serkalem
AU - Jackson, Debra J.
AU - Lang, Janet M.
AU - Ecker, Jeffrey L.
PY - 2009/3/1
Y1 - 2009/3/1
N2 - Using data from the San Diego Birth Center Study that enrolled underserved women between 1994 and 1996, we examined demographic, sociobehavioral, and medical predictors of hospital transfer in a group of women who intended to deliver at a freestanding birth center. Of the 1808 women, 34.6% transferred to the hospital antenatally and 19.6% transferred during labor, while 45.7% delivered at the birth center. Compared with multiparous women who had never had a cesarean and never had a previous hospital delivery, nulliparous women were 2.0 times more likely (95% confidence interval [CI], 1.4-2.7), multiparous women with a previous cesarean were 2.6 times more likely (95% CI, 1.7-3.8), and women without a previous cesarean but who had a previous hospital delivery were 2.1 times more likely (95% CI, 1.5-3.0) to transfer after adjusting for other predictors of transfer. Nulliparity, cesarean history and having a previous hospital delivery were among the strongest predictors of a hospital transfer even after adjusting for demographic, sociobehavioral, and other medical conditions. Understanding predictors of transfer may assist practitioners, patients, and policy makers in considering the appropriateness of individuals for birth center delivery or to target further education to reduce nonmedical transfers.
AB - Using data from the San Diego Birth Center Study that enrolled underserved women between 1994 and 1996, we examined demographic, sociobehavioral, and medical predictors of hospital transfer in a group of women who intended to deliver at a freestanding birth center. Of the 1808 women, 34.6% transferred to the hospital antenatally and 19.6% transferred during labor, while 45.7% delivered at the birth center. Compared with multiparous women who had never had a cesarean and never had a previous hospital delivery, nulliparous women were 2.0 times more likely (95% confidence interval [CI], 1.4-2.7), multiparous women with a previous cesarean were 2.6 times more likely (95% CI, 1.7-3.8), and women without a previous cesarean but who had a previous hospital delivery were 2.1 times more likely (95% CI, 1.5-3.0) to transfer after adjusting for other predictors of transfer. Nulliparity, cesarean history and having a previous hospital delivery were among the strongest predictors of a hospital transfer even after adjusting for demographic, sociobehavioral, and other medical conditions. Understanding predictors of transfer may assist practitioners, patients, and policy makers in considering the appropriateness of individuals for birth center delivery or to target further education to reduce nonmedical transfers.
KW - birth center delivery
KW - cesarean section
KW - hospital delivery
KW - model of care
KW - multiparity
KW - nulliparity
KW - obstetric care
KW - perinatal care
KW - transfers
UR - http://www.scopus.com/inward/record.url?scp=60649105554&partnerID=8YFLogxK
U2 - 10.1016/j.jmwh.2008.11.002
DO - 10.1016/j.jmwh.2008.11.002
M3 - Article
C2 - 19249655
AN - SCOPUS:60649105554
SN - 1526-9523
VL - 54
SP - 104
EP - 110
JO - Journal of Midwifery and Women's Health
JF - Journal of Midwifery and Women's Health
IS - 2
ER -