{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T10:43:27Z","timestamp":1777632207693,"version":"3.51.4"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T00:00:00Z","timestamp":1609286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Current US guidelines for the care of women with obesity generalize obesity\u2010related risks to all women regardless of overall health status and assume that birth will occur in hospitals. Perinatal outcomes for women with obesity in US freestanding birth centers need documentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pregnancies recorded in the American Association of Birth Centers Perinatal Data Registry were analyzed (n = 4,455) to form 2 groups of primiparous women (n = 964; 1:1 matching of women with normal body mass indices [BMIs] and women with obese BMIs [<jats:styled-content>&gt;<\/jats:styled-content>30]), using propensity score matching to address the imbalance of potential confounders. Groups were compared on a range of outcomes. Differences between groups were evaluated using \u03c7<jats:sup>2<\/jats:sup> test for categorical variables and Student's <jats:italic>t<\/jats:italic> test for continuous variables. Paired <jats:italic>t<\/jats:italic> test and McNemar's test evaluated the differences among the matched pairs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The majority of women with obese BMIs experienced uncomplicated perinatal courses and vaginal births. There were no significant differences in antenatal complications, proportion of prolonged pregnancy, prolonged first and second stage labor, rupture of membranes longer than 24 hours, postpartum hemorrhage, or newborn outcomes between women with obese BMIs and normal BMIs. Among all women with intrapartum referrals or transfers (25.3%), the primary indications were prolonged first stage or second stage (55.4%), inadequate pain relief (14.8%), client choice or psychological issue (7.0%), and meconium (5.3%). Primiparous women with obesity who started labor at a birth center had a 30.7% transfer rate and an 11.1% cesarean birth rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Women with obese BMIs without medical comorbidity can receive safe and effective midwifery care at freestanding birth centers while anticipating a low risk for cesarean birth. The risks of potential, obesity\u2010related perinatal complications should be discussed with women when choosing place of birth; however, pregnancy complicated by obesity must be viewed holistically, not simply through the lens of obesity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jmwh.13194","type":"journal-article","created":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T12:59:30Z","timestamp":1609333170000},"page":"14-23","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Birth Outcomes of Women with Obesity Enrolled for Care at Freestanding Birth Centers in the United States"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4574-5650","authenticated-orcid":false,"given":"Cecilia M.","family":"Jevitt","sequence":"first","affiliation":[{"name":"University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Stapleton","sequence":"additional","affiliation":[{"name":"American Association of Birth Centers  Perkiomenville Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanhong","family":"Deng","sequence":"additional","affiliation":[{"name":"Yale Center for Analytical Sciences Yale School of Public Health  New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuemei","family":"Song","sequence":"additional","affiliation":[{"name":"Yale Center for Analytical Sciences Yale School of Public Health  New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaicheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Yale Center for Analytical Sciences Yale School of Public Health  New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana R.","family":"Jolles","sequence":"additional","affiliation":[{"name":"American Association of Birth Centers  Perkiomenville Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,30]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"American Association of Birth Centers.Definition of a Birth Center. 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