Cautions over rise in unbooked births

Detailed in the Midwifery Journal, researchers found the incidence of unplanned or unbooked births before arrival (BBAs), meaning a birth took place before women arrive at hospital or in a home birth before the midwife arrived, had doubled during the data collection period.

The findings were based on data from The Australian Institute of Health and Wellbeing and the Perinatal Data Collection Unit of Victoria between 1991 and 2008.

Led by Gayle McLelland, from Monash University’s School of Nursing and Midwifery, the study also found the health outcomes of both the mother and her baby were significantly poorer after an unplanned birth outside hospital care in comparison to planned home or hospital births.

Ms. McLelland said multiple approaches should be adopted by health practitioners to identify women most at risk of an unplanned birth and to manage them when they occur.

“An unplanned birth outside hospital care is usually unexpected but has occurred for more than 1000 Australian women each year since 2003.  In 2008 close to 1500 women experienced an unplanned birth without a midwife or medical practitioner present,” Ms. McLelland said.

“While most babies born in this situation are at their full term, there is a reported higher probability of a premature baby. Complications for the women and particularly the babies are increased and although fortunately rare, death can occur.

“Skilled care before, during and after childbirth is important to the health of women and newborns. Strategies should be developed to optimise maternal and neonatal outcomes, including screening to identify the women most at risk.”

Ms. McLelland said education for women and their partners in the immediate management of a newborn was important. Further, paramedics should be equipped with current knowledge and resources to care for women during pregnancy and childbirth.

The study also concluded the number of unplanned BBAs in Australia was comparible to rates in other developed countries.

Provided by Monash University