Twin home birth: Outcomes of 100 sets of twins in the care of a single practitioner
Research on community (home or birth center) twin birth is scarce. This study evaluates outcomes of twin pregnancies entering care with a single community practitioner. This is a retrospective observational cohort study of 100 consecutive twin pregnancies planning community births during a 12-year p...
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| description | Research on community (home or birth center) twin birth is scarce. This study evaluates outcomes of twin pregnancies entering care with a single community practitioner.
This is a retrospective observational cohort study of 100 consecutive twin pregnancies planning community births during a 12-year period. Outcomes measured included mode of birth; birth weights; Apgar scores; ante-, intra-, and post-partum transports; perineal integrity; birth interval; blood loss; chorionicity; weight concordance; and other maternal or neonatal morbidity.
31 women (31%) transferred to a hospital-based clinician prior to labor. Of the 69 pregnancies still under the obstetrician's care when labor began, 79.7% (n = 55) were Dichorionic Diamniotic and 21.3% (n = 14) were Monochorionic Diamniotic. The vaginal birth rate was 91.3% (n = 63): 77.3% for primips and functional primips (no previous vaginal births) and 97.9% for multips. Six mothers (8.7%) had in-labor cesareans (1 multip and 5 primips). Rates of vaginal birth did not vary significantly by chorionicity. There were 8 transports in labor (11.6%): 2 vaginal and 6 cesareans. Average gestational age was 39.0 weeks (range 35-42). Compared to primiparas, multiparas had less perineal trauma and higher rates of vaginal birth and spontaneous vaginal birth. One twin infant and one mother required postpartum hospital transport. Of the babies born in a community setting, there was no serious morbidity requiring hospital treatment.
A community birth can lead to high rates of vaginal birth and good outcomes for both mothers and babies in properly selected twin pregnancies. Community twin birth with midwifery style care under specific protocol guidelines and with a skilled practitioner may be a reasonable choice for women wishing to avoid a cesarean section-especially when there is no option of a hospital vaginal birth. Training all practitioners in vaginal twin and breech birth skills remains an imperative. |
| doi_str_mv | 10.1371/journal.pone.0313941 |
| format | Article |
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This is a retrospective observational cohort study of 100 consecutive twin pregnancies planning community births during a 12-year period. Outcomes measured included mode of birth; birth weights; Apgar scores; ante-, intra-, and post-partum transports; perineal integrity; birth interval; blood loss; chorionicity; weight concordance; and other maternal or neonatal morbidity.
31 women (31%) transferred to a hospital-based clinician prior to labor. Of the 69 pregnancies still under the obstetrician's care when labor began, 79.7% (n = 55) were Dichorionic Diamniotic and 21.3% (n = 14) were Monochorionic Diamniotic. The vaginal birth rate was 91.3% (n = 63): 77.3% for primips and functional primips (no previous vaginal births) and 97.9% for multips. Six mothers (8.7%) had in-labor cesareans (1 multip and 5 primips). Rates of vaginal birth did not vary significantly by chorionicity. There were 8 transports in labor (11.6%): 2 vaginal and 6 cesareans. Average gestational age was 39.0 weeks (range 35-42). Compared to primiparas, multiparas had less perineal trauma and higher rates of vaginal birth and spontaneous vaginal birth. One twin infant and one mother required postpartum hospital transport. Of the babies born in a community setting, there was no serious morbidity requiring hospital treatment.
A community birth can lead to high rates of vaginal birth and good outcomes for both mothers and babies in properly selected twin pregnancies. Community twin birth with midwifery style care under specific protocol guidelines and with a skilled practitioner may be a reasonable choice for women wishing to avoid a cesarean section-especially when there is no option of a hospital vaginal birth. Training all practitioners in vaginal twin and breech birth skills remains an imperative.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0313941</identifier><identifier>PMID: 39661588</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Biology and Life Sciences ; Birth ; Birth rate ; Birth Weight ; Birthing centers ; Cesarean section ; Childbirth & labor ; Childbirth at home ; Clinical medicine ; Complications and side effects ; COVID-19 ; Delivery, Obstetric - statistics & numerical data ; Female ; Gestational age ; Health aspects ; Home births ; Home Childbirth - statistics & numerical data ; Hospitals ; Humans ; Infant, Newborn ; Labor ; Medicine and Health Sciences ; Midwifery ; Morbidity ; Multiple birth ; Multiple births ; Neonates ; Observational studies ; Patient outcomes ; People and Places ; Perineum ; Postpartum period ; Pregnancy ; Pregnancy Outcome - epidemiology ; Pregnancy, Twin ; Retrospective Studies ; Stillbirth ; Surveillance ; Twins ; Vagina ; Women ; Womens health</subject><ispartof>PloS one, 2024-12, Vol.19 (12), p.e0313941</ispartof><rights>Copyright: © 2024 Fischbein, Freeze. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Fischbein, Freeze. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Fischbein, Freeze 2024 Fischbein, Freeze</rights><rights>2024 Fischbein, Freeze. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c572t-73654554a7a32f5750b5f24124b576d3b61e8f85e65a461eaeb384299d07fa963</cites><orcidid>0009-0007-2354-590X ; 0009-0006-7928-8327</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633979/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633979/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23847,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39661588$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Sljivancanin Jakovljevic, Tamara</contributor><creatorcontrib>Fischbein, Stuart J</creatorcontrib><creatorcontrib>Freeze, Rixa</creatorcontrib><title>Twin home birth: Outcomes of 100 sets of twins in the care of a single practitioner</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Research on community (home or birth center) twin birth is scarce. This study evaluates outcomes of twin pregnancies entering care with a single community practitioner.
This is a retrospective observational cohort study of 100 consecutive twin pregnancies planning community births during a 12-year period. Outcomes measured included mode of birth; birth weights; Apgar scores; ante-, intra-, and post-partum transports; perineal integrity; birth interval; blood loss; chorionicity; weight concordance; and other maternal or neonatal morbidity.
31 women (31%) transferred to a hospital-based clinician prior to labor. Of the 69 pregnancies still under the obstetrician's care when labor began, 79.7% (n = 55) were Dichorionic Diamniotic and 21.3% (n = 14) were Monochorionic Diamniotic. The vaginal birth rate was 91.3% (n = 63): 77.3% for primips and functional primips (no previous vaginal births) and 97.9% for multips. Six mothers (8.7%) had in-labor cesareans (1 multip and 5 primips). Rates of vaginal birth did not vary significantly by chorionicity. There were 8 transports in labor (11.6%): 2 vaginal and 6 cesareans. Average gestational age was 39.0 weeks (range 35-42). Compared to primiparas, multiparas had less perineal trauma and higher rates of vaginal birth and spontaneous vaginal birth. One twin infant and one mother required postpartum hospital transport. Of the babies born in a community setting, there was no serious morbidity requiring hospital treatment.
A community birth can lead to high rates of vaginal birth and good outcomes for both mothers and babies in properly selected twin pregnancies. Community twin birth with midwifery style care under specific protocol guidelines and with a skilled practitioner may be a reasonable choice for women wishing to avoid a cesarean section-especially when there is no option of a hospital vaginal birth. 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epidemiology</subject><subject>Pregnancy, Twin</subject><subject>Retrospective Studies</subject><subject>Stillbirth</subject><subject>Surveillance</subject><subject>Twins</subject><subject>Vagina</subject><subject>Women</subject><subject>Womens health</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNkluL1DAUx4so7kW_gWhBWPRhxqS5NPFFlsXLwMKAu_oa0va0zdBpxiT18u1NZ7rLVPZB8tDTk9_5J-fknyQvMFpikuN3Gzu4XnfLne1hiQgmkuJHySmWJFvwDJHHR_FJcub9BiFGBOdPkxMiOcdMiNPk5vaX6dPWbiEtjAvt-3Q9hDL--tTWKUYo9RD2cYigTyMcWkhL7WBM6tSbvukg3TldBhNMvIx7ljypdefh-fQ9T759-nh79WVxvf68urq8XpQsz8IiJ5xRxqjONclqljNUsDqjOKMFy3lFCo5B1IIBZ5rGWENBBM2krFBea8nJefLqoLvrrFfTPLwimJIsk5SSSKwORGX1Ru2c2Wr3R1lt1D5hXaO0C6bsQHEiRZazqq4AUWBUIKR1RUGgHGEEMmp9mE4bii1UJfTB6W4mOt_pTasa-1NhzAmR-ajwZlJw9scAPqit8SV0ne7BDvuLc86QICKir_9BH25vohodOzB9bePB5SiqLgWWXNLYUaSWD1BxVbA1ZXyw2sT8rODtrCAyAX6HRg_eq9XN1_9n19_n7MUR24LuQuttN4yu8XOQHsDSWe8d1PdTxkiN5r-bhhrNrybzx7KXxy90X3TndvIXirj7pw</recordid><startdate>20241211</startdate><enddate>20241211</enddate><creator>Fischbein, Stuart J</creator><creator>Freeze, Rixa</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>COVID</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0009-0007-2354-590X</orcidid><orcidid>https://orcid.org/0009-0006-7928-8327</orcidid></search><sort><creationdate>20241211</creationdate><title>Twin home birth: Outcomes of 100 sets of twins in the care of a single practitioner</title><author>Fischbein, Stuart J ; Freeze, Rixa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c572t-73654554a7a32f5750b5f24124b576d3b61e8f85e65a461eaeb384299d07fa963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Biology and Life Sciences</topic><topic>Birth</topic><topic>Birth rate</topic><topic>Birth Weight</topic><topic>Birthing centers</topic><topic>Cesarean section</topic><topic>Childbirth & labor</topic><topic>Childbirth at home</topic><topic>Clinical medicine</topic><topic>Complications and side effects</topic><topic>COVID-19</topic><topic>Delivery, Obstetric - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fischbein, Stuart J</au><au>Freeze, Rixa</au><au>Sljivancanin Jakovljevic, Tamara</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Twin home birth: Outcomes of 100 sets of twins in the care of a single practitioner</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-12-11</date><risdate>2024</risdate><volume>19</volume><issue>12</issue><spage>e0313941</spage><pages>e0313941-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Research on community (home or birth center) twin birth is scarce. This study evaluates outcomes of twin pregnancies entering care with a single community practitioner.
This is a retrospective observational cohort study of 100 consecutive twin pregnancies planning community births during a 12-year period. Outcomes measured included mode of birth; birth weights; Apgar scores; ante-, intra-, and post-partum transports; perineal integrity; birth interval; blood loss; chorionicity; weight concordance; and other maternal or neonatal morbidity.
31 women (31%) transferred to a hospital-based clinician prior to labor. Of the 69 pregnancies still under the obstetrician's care when labor began, 79.7% (n = 55) were Dichorionic Diamniotic and 21.3% (n = 14) were Monochorionic Diamniotic. The vaginal birth rate was 91.3% (n = 63): 77.3% for primips and functional primips (no previous vaginal births) and 97.9% for multips. Six mothers (8.7%) had in-labor cesareans (1 multip and 5 primips). Rates of vaginal birth did not vary significantly by chorionicity. There were 8 transports in labor (11.6%): 2 vaginal and 6 cesareans. Average gestational age was 39.0 weeks (range 35-42). Compared to primiparas, multiparas had less perineal trauma and higher rates of vaginal birth and spontaneous vaginal birth. One twin infant and one mother required postpartum hospital transport. Of the babies born in a community setting, there was no serious morbidity requiring hospital treatment.
A community birth can lead to high rates of vaginal birth and good outcomes for both mothers and babies in properly selected twin pregnancies. Community twin birth with midwifery style care under specific protocol guidelines and with a skilled practitioner may be a reasonable choice for women wishing to avoid a cesarean section-especially when there is no option of a hospital vaginal birth. Training all practitioners in vaginal twin and breech birth skills remains an imperative.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>39661588</pmid><doi>10.1371/journal.pone.0313941</doi><tpages>e0313941</tpages><orcidid>https://orcid.org/0009-0007-2354-590X</orcidid><orcidid>https://orcid.org/0009-0006-7928-8327</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adult Biology and Life Sciences Birth Birth rate Birth Weight Birthing centers Cesarean section Childbirth & labor Childbirth at home Clinical medicine Complications and side effects COVID-19 Delivery, Obstetric - statistics & numerical data Female Gestational age Health aspects Home births Home Childbirth - statistics & numerical data Hospitals Humans Infant, Newborn Labor Medicine and Health Sciences Midwifery Morbidity Multiple birth Multiple births Neonates Observational studies Patient outcomes People and Places Perineum Postpartum period Pregnancy Pregnancy Outcome - epidemiology Pregnancy, Twin Retrospective Studies Stillbirth Surveillance Twins Vagina Women Womens health |
| title | Twin home birth: Outcomes of 100 sets of twins in the care of a single practitioner |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T11%3A00%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Twin%20home%20birth:%20Outcomes%20of%20100%20sets%20of%20twins%20in%20the%20care%20of%20a%20single%20practitioner&rft.jtitle=PloS%20one&rft.au=Fischbein,%20Stuart%20J&rft.date=2024-12-11&rft.volume=19&rft.issue=12&rft.spage=e0313941&rft.pages=e0313941-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0313941&rft_dat=%3Cgale_plos_%3EA819694275%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3143229443&rft_id=info:pmid/39661588&rft_galeid=A819694275&rft_doaj_id=oai_doaj_org_article_6398275dfde04e54800aad4e807010e9&rfr_iscdi=true |