{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T07:49:13Z","timestamp":1772696953657,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,7,23]],"date-time":"2015-07-23T00:00:00Z","timestamp":1437609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"funder":[{"name":"Policy Research Programme in the Department of Health"},{"name":"National Institute for Health Research Service Delivery and Organisation (NIHR SDO) programme"},{"name":"Department of Health Policy Research Programme (DH PRP)"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare vaginal birth rates in women planning vaginal birth after caesarean (<jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content>) at home versus in an obstetric unit (<jats:styled-content style=\"fixed-case\">OU<\/jats:styled-content>) and explore transfer rates in women planning home <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">OU<\/jats:styled-content>s and planned home births in England.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>1436 women planning <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content> in the Birthplace cohort, including 209 planning home <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used Poisson regression to calculate relative risks adjusted for maternal characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Main outcomes: (i) vaginal birth and (ii) transfer from planned home birth to <jats:styled-content style=\"fixed-case\">OU<\/jats:styled-content> during labour or immediately after birth. Secondary outcomes: (i) composite of maternal blood transfusion or admission to higher level care, (ii) stillbirth or Apgar score &lt;7 at 5\u00a0minutes, (iii) neonatal unit admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Planned <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content> at home was associated with a statistically significant increase in the chances of having a vaginal birth compared with planned <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content> in an <jats:styled-content style=\"fixed-case\">OU<\/jats:styled-content> (adjusted relative risk 1.15, 95% confidence interval 1.06\u20131.24). The risk of an adverse maternal outcome was around 2\u20133% in both settings, with a similar risk of an adverse neonatal outcome. Transfer rates were high (37%) and varied markedly by parity (para 1, 56.7% versus para 2+, 24.6%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Women in the cohort who planned <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content> at home had an increased chance of a vaginal birth compared with those planning <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content> in an <jats:styled-content style=\"fixed-case\">OU<\/jats:styled-content>, but transfer rates were high, particularly for women with only one previous birth, and the risk of an adverse maternal or perinatal outcome was around 2\u20133%. No change in guidance can be recommended.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Higher vaginal birth rates in planned <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content> at home versus in <jats:styled-content style=\"fixed-case\">OU<\/jats:styled-content> but 2\u20133% adverse outcomes and high transfer rate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13546","type":"journal-article","created":{"date-parts":[[2015,7,25]],"date-time":"2015-07-25T22:46:51Z","timestamp":1437864411000},"page":"1123-1132","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Maternal and perinatal outcomes in women planning vaginal birth after caesarean (<scp>VBAC<\/scp>) at home in England: secondary analysis of the Birthplace national prospective cohort study"],"prefix":"10.1111","volume":"123","author":[{"given":"R","family":"Rowe","sequence":"first","affiliation":[{"name":"Policy Research Unit in Maternal Health and Care National Perinatal Epidemiology Unit Nuffield Department of Population Health University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y","family":"Li","sequence":"additional","affiliation":[{"name":"Policy Research Unit in Maternal Health and Care National Perinatal Epidemiology Unit Nuffield Department of Population Health University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Knight","sequence":"additional","affiliation":[{"name":"Policy Research Unit in Maternal Health and Care National Perinatal Epidemiology Unit Nuffield Department of Population Health University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Brocklehurst","sequence":"additional","affiliation":[{"name":"Policy Research Unit in Maternal Health and Care National Perinatal Epidemiology Unit Nuffield Department of Population Health University of Oxford Oxford UK"},{"name":"Institute for Women's Health University College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Hollowell","sequence":"additional","affiliation":[{"name":"Policy Research Unit in Maternal Health and Care National Perinatal Epidemiology Unit Nuffield Department of Population Health University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,7,23]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"The National Sentinel Caesarean Section\u00a0Audit Report","author":"Clinical Effectiveness Support Unit","year":"2001"},{"key":"e_1_2_8_3_1","volume-title":"Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth. 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