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List of milestones

  • Coverage Guidance (pending)
  • Changes to the Prioritized List (pending)

To view the meeting material and minutes mentioned on this blog, please visit the public meetings page

Planned out-of-hospital birth

Next Steps:
VbBS and HERC will review this topic at their 8/13/2015 meeting.

EbGS concluded its review of public comments, updated the coverage guidance and referred it to HERC.

New references added:

Birthplace in England Collaborative Group; Brocklehurst, P., Hardy, P., Hollowell, J., Linsell, L., Macfarlane, A., McCourt, C. … Stewart, M. (2011). Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: The Birthplace in England national prospective cohort study. British Medical Journal, 343, d7400. http://www.bmj.com/content/343/bmj.d7400.full.pdf+html 

Catling-Paull, C., Coddington, R. L., Foureur, M. J., Homer, C. S.; Birthplace in Australia Study; National Publically-funded Homebirth Consortium. (2013). Publically funded homebirth in Australia: A review of maternal and neonatal outcomes over 6 years. Medical Journal of Australia, 198(11), 616-20. https://www.mja.com.au/system/files/issues/198_11_170613/cat11665_fm.pdf 

Cheng, Y. W., Snowden, J. M., King, T. L., & Caughey, A. B. (2013). Selected perinatal outcomes associated with planned home births in the United States. American Journal of Obstetrics & Gynecology, 209(4), 325.e1-8. http://www.ajog.org/article/S0002-9378(13)00630-3/pdf 

Cheyney, M., Bovbjerg, M., Everson, C., Gordon, W., Hannibal , D., & Verdam, S. (2014). Outcomes of care for 16,924 planned home births in the United States: the Midwives Alliance of North America Statistics Project, 2004-2009.  Journal of Midwifery & Women’s Health, 59(1), 17-27. http://onlinelibrary.wiley.com/doi/10.1111/jmwh.12172/epdf 

Davis, D., Baddock, S., Paiman, S., Hunter, M., Benn, C., Anderson, J. … Herbison, P. (2012). Risk of severe postpartum hemorrhage in low-risk childbearing women in New Zealand: Exploring the effect of place of birth and comparing third stage management of labor. Birth, 39(2), 98-105. DOI: 10.1111/j.1523-536X.2012.00531.x 

de Jonge, A., Mesman, J. A., Mannien, J., Zwart, J. J., van Dillen, J., & van Roosmalen, J. (2013). Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: Nationwide cohort study. British Medical Journal, 346, f3263. http://www.bmj.com/content/346/bmj.f3263.full.pdf+html 

de Jonge, A., Geerts, C. C., van der Goes, B. Y., Mol, B. W., Buitendijk, S. E., & Nijuhuis, J. G. (2015). Perinatal mortality and morbidity up to 28 days after birth among 743,070 low-risk planned home and hospital births: A cohort study based on three merged national perinatal databases. British Journal of Obstetrics and Gynecology, 122(5), 720-728. http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.13084/epdf 

Grünebaum A, McCullough LB, Brent RL, et al. Perinatal risks of planned home births in the United States. American Journal of Obstetrics and Gynecology 2015;212:350.e1-6. http://www.ajog.org/article/S0002-9378%2814%2901063-1/abstract 

Johnson, K. C., & Daviss, B. A. (2005). Outcomes of planned home births with certified professional midwives: Large prospective study in North America. British Medical Journal, 330(7505), 1416. http://www.bmj.com/content/330/7505/1416.full.pdf+html 

Kennare, R. M., Keirse, M. J., Tucker, G. R., & Chan, A. C. (2010). Planned home and hospital births in South Australia, 1991-2006: Differences in outcomes. Medical Journal of Australia, 192(2), 76-80. https://www.mja.com.au/system/files/issues/192_02_180110/ken10465_fm.pdf

Nove, A., Berrington, A., & Matthews, Z. (2012). Comparing the odds of postpartum haemorrhage in planned home birth against planned hospital birth: Results of an observational study of over 500,000 maternities in the UK. BMC Pregnancy & Childbirth, 12, 130. http://www.biomedcentral.com/content/pdf/1471-2393-12-130.pdf 

Stapleton, S. R., Osborne, C., & Illuzzi, J. (2013). Outcomes of care in birth centers: Demonstration of a durable model. Journal of Midwifery & Women’s Health, 58(1), 3-14. http://onlinelibrary.wiley.com/doi/10.1111/jmwh.12003/epdf 

van der Kooy, J., Poeran, J., de Graaf, J. P., Bimie, E., Denklass, S., Steegers, E. A., & Bonsel, G. J. (2011). Planned home compared with planned hospital births in the Netherlands: Intrapartum and early neonatal death in low-risk pregnancies. Obstetrics & Gynecology, 118(5), 1037-46. DOI: 10.1097/AOG.0b013e3182319737    


EbGS continued its review of public comments but did not complete its review. EbGS will continue its review 6/4/2015.


EbGS reviewed public comment on the draft coverage guidance at its meeting February 5, 2015. The title was changed from "Home birth" to "Planned out-of-hospital birth."  The subcommittee requested new research from staff regarding risks to primaparous women. Discussion of public comments will continue at the 4/2/2015 EbGS meeting.


One of the source reports for this coverage guidance has been updated. The new citation is:

National Institute for Clinical Excellence (2014). Intrapartum care: care of healthy women and their babies during childbirth. Clinical Guideline 190, December 2014. Accessed December 15, 2014, from https://www.nice.org.uk/guidance/cg190/resources/guidance-intrapartum-care-care-of-healthy-women-and-their-babies-during-childbirth-pdf


The draft coverage guidance has been posted for public comment. The public comment period ends at 8 a.m. Pacific time on December 15, 2014.


EbGS revised the draft coverage guidance and asked that it be posted for a 30-day public comment period.​


Updated source added:
College of Midwives of Ontario (2014). Consultation and transfer of care. Accessed October 1, 2014, from http://www.cmo.on.ca/?page_id=1026


EbGS discussed the draft coverage guidance and will continue discussion at its meeting 11/6/2014.


A new source has been added to this coverage guidance:

National Institute for Clinical Excellence (2014). Intrapartum care: care of healthy women and their babies during childbirth Clinical Guideline 55, Draft for consultation, May 2014. Accessed August 12, 2014 from http://www.nice.org.uk/guidance/gid-cgwaver109/resources/intrapartum-care-update-nice-guideline2

Trusted Sources

Olsen, O., & Clausen, J. A. (2012). Planned hospital birth versus planned home birth. Cochrane Database of Systematic Reviews, 9.

Additional Sources
Cochrane, A. L. (2000). 1931-1971: a critical review, with particular reference to the medical profession. Medicines for the year, 1-11.

College of Midwives of British Columbia. (2014). Indications for discussion, consultation, and transfer of care. Accessed August 4, 2014 from http://www.cmbc.bc.ca/pdf.shtml?Registrants-Handbook-12-01-Indications-for-Discussion-Consultation-and-Transfer-of-Care

College of Midwives of Ontario (2000). Indications for mandatory discussion, consultation, and transfer of care. Accessed August 4, 2014 from http://www.cmo.on.ca/resources/STANDARDS-OF-PRACTICE/3.%20CLINICAL%20PRACTICE/05b.Indications%20for%20Mandatory%20Discussion%20Consultation%20and%20Transfer_June%202000.pdf

de Jonge, A., van der Goes, B. Y., Ravelli, A. C., Amelink‐Verburg, M. P., Mol, B. W., Nijhuis, J. G., et al. (2009). Perinatal mortality and morbidity in a nationwide cohort of 529, 688 low‐risk planned home and hospital births. BJOG: An International Journal of Obstetrics & Gynaecology, 116(9), 1177-1184.

Dowswell, T., Thornton, J. G., Hewison, J., Lilford, R. J., Raisler, J., MacFarlane, A., et al.(1996). Should there be a trial of home versus hospital delivery in the United Kingdom? BMJ: British Medical Journal,312(7033), 753.

Hendrix, M., Van Horck, M., Moreta, D., Nieman, F., Nieuwenhuijze, M., Severens, J., et al. (2009). Why women do not accept randomisation for place of birth: feasibility of a RCT in the Netherlands. BJOG: An International Journal of Obstetrics & Gynaecology, 116(4), 537-544.

Hutton, E. K., Reitsma, A. H., & Kaufman, K. (2009). Outcomes Associated with Planned Home and Planned Hospital Births in Low‐Risk Women Attended by Midwives in Ontario, Canada, 2003–2006: A Retrospective Cohort Study. Birth, 36(3), 180-189.

Janssen, P. A., Saxell, L., Page, L. A., Klein, M. C., Liston, R. M., & Lee, S. K. (2009). Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. Canadian Medical Association Journal, 181(6-7), 377-383.

Netherlands Ministry of Health, Welfare, and Sport. (n.d). Final Report of the Obstetric Working Group of the National Health Insurance Board of the Netherlands (abridged version). The Hauge, NL: Government of the Netherlands. Accessed August 4, 2014 from http://blog.lib.umn.edu/kuli0015/studygroup/Dutch%20OB%20Indications.doc

Oregon Health Authority. (2013). Oregon Birth Outcomes by Planned Birth Place and Attendant. Accessed August 1, 2014 from https://public.health.oregon.gov/BirthDeathCertificates/VitalStatistics/birth/Documents/PlannedBirthPlaceandAttendant.pdf

Wax, J. R., Lucas, F. L., Lamont, M., Pinette, M. G., Cartin, A., & Blackstone, J. (2010). Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis. American journal of obstetrics and gynecology,203(3), 243-e1.

Zeitlin, J., Mohangoo, A., Alexander, S., Barros, H., Blondel, B., Bouvier-Colle, et al. (n.d). Health and Care of Pregnant Women and Babies in Europe in 2010. Accessed on August 1, 2014 from http://www.europeristat.com/images/doc/Peristat%202013%20V2.pdf

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