Distance to Hospital ‐based Intrapartum Care and Planned Home Birth in Minnesota

This study explores the impact of distance to hospital‐based intrapartum care on planned home birth.MethodsPublic ‐use Minnesota birth certificate data were merged with Minnesota Hospital Annual Report data (2011‐2016) to test the relationship of miles from maternal residence to hospital‐based intrapartum care with planned home birth in Minnesota. Logistic regression models estimated the odds of a planned home birth versus hospital birth as a function of miles to hospital‐based intrapartum care.ResultsThe number of hospitals offering birth services in Minnesota declined by 11% from 2011 to 2016. Moderate (>20 ‐50 miles) and great (>50 miles) distances to nearest hospital ‐based intrapartum care were associated with increased odds of planned home birth compared with short distances (≤20 miles). Adjusted odds ratios were 3.31 (95% CI, 3.04‐3.61) and 3.89 (95% CI, 2.37‐6.37), respectively, after adjusting for maternal education, age, and race. Planned home birt h was the intended birth setting in 4.3% of births among those living great distances from hospital‐based intrapartum care, compared with 1.0% among those living a short distance from hospital‐based intrapartum care.DiscussionBetter understanding of how geographical barriers affect preferred birth settings can inform efforts to reduce the impact of hospital ‐based intrapartum service loss on rural women and their birth outcomes.
Source: Journal of Midwifery and Women's Health - Category: Midwifery Authors: Tags: Original Research Source Type: research