Estimation of transfers of care in planned homebirths using decision analytic modelling

Abstract

This project addresses Aim (3) and was designed to estimate antenatal, intrapartum and postpartum transfer rates based on the population of low risk women who planned hospital birth and who were eligible for planned homebirth. Decision analytic modelling was used to construct a pregnancy model using data for low risk planned metropolitan hospital births from 2011 to 2013, in accordance with changes in guidelines for homebirth released by WA Health in 2011 [2]. The pregnancy model previously developed by Doherty et al. (2009) was constructed to model pregnancy outcomes using maternal characteristics and pregnancy complications predictive of adverse maternal and neonatal outcomes. The accuracy of the simulated pregnancy outcomes were evaluated by comparison with observed data. A large hypothetical dataset was generated with characteristics and events that reflected the homebirth population [4]. The model facilitated the evaluation of pregnancy outcomes and transfers in homebirth women and will enable future comparisons of observed and expected rates of obstetric interventions, adverse outcomes and transfers.