{
  "abstract": "Aim: To compare outcomes of planned home or freestanding midwifery unit (FMU) with obstetric unit births in high‐income countries.\n\nMethods: We conducted a systematic review and meta‐analysis of systematic reviews, randomised controlled trials, cohort studies, case series, and case reports. Medline, Embase, CINAHL and the Cochrane Library were searched up to 8 April 2026 (PROSPERO: CRD42024570558). Outcomes included maternal and peri/neonatal mortality, severe morbidity, hospital transfers and health economics. Certainty of evidence was assessed using GRADE.\n\nResults: Nine cohort studies (n = 1 261 312), 18 case series, and three case reports were included. All cohort studies had a risk of bias. Planned home/FMU births were associated with fewer maternal intensive care admissions (adjusted odds ratio [AOR] 0.41, 95% confidence interval [95% CI] 0.19–0.89), increased peri/neonatal mortality (OR 1.70, 95% CI 1.05–2.74), fewer severe perineal tears (AOR 0.64, 95% CI 0.45–0.93), and lower intrapartum caesarean section rates (AOR 0.29, 95% CI 0.26–0.33). Transfers occurred in 9%–33% of births. Cost savings for home/FMU births disappeared when emergency standby capacity was considered.\n\nConclusion: Evidence certainty was low or very low. Planned home/FMU births may reduce some maternal complications but may increase peri/neonatal mortality, although absolute risks remain low. The cost‐effectiveness of home/FMU birth remains uncertain.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Obstetrics and Gynecology Sahlgrenska University Hospital Gothenburg Sweden",
    "Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden",
    "Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden",
    "Department of Pediatrics, The Queen Silvia Children's Hospital Sahlgrenska University Hospital Gothenburg Sweden",
    "Institute of Health and Care Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden",
    "Centre for Health Technology Assessment Sahlgrenska University Hospital Gothenburg Sweden",
    "School of Public Health and Community Medicine, Institute of Medicine University of Gothenburg Gothenburg Sweden",
    "Department of International Public Health Liverpool School of Tropical Medicine Liverpool UK",
    "Medical Library Sahlgrenska University Hospital Gothenburg Sweden"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Carolina Herding"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ulla‐Britt Wennerholm"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Anders Elfvin",
      "orcid": "0000-0002-1912-9563"
    },
    {
      "affs": [
        0
      ],
      "name": "Sara Holm"
    },
    {
      "affs": [
        4
      ],
      "name": "Karolina Linden",
      "orcid": "0000-0002-2792-3142"
    },
    {
      "affs": [
        5,
        6,
        7
      ],
      "name": "Jahangir Khan"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Max Petzold"
    },
    {
      "affs": [
        1,
        5
      ],
      "name": "Christina Bergh"
    },
    {
      "affs": [
        5
      ],
      "name": "Petteri Sjögren"
    },
    {
      "affs": [
        8
      ],
      "name": "Ida Stadig"
    },
    {
      "affs": [
        8
      ],
      "name": "Ann Liljegren"
    },
    {
      "affs": [
        1,
        5
      ],
      "name": "Ylva Carlsson",
      "orcid": "0000-0002-1414-7279"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Verena Sengpiel",
      "orcid": "0000-0002-3608-7430"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/c207yxsj11yh3.bib",
  "cited_by": 0,
  "doi": "10.1111/apa.70685",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13747683/",
  "id": "c207yxsj11yh3",
  "issns": [
    "0803-5253",
    "1651-2227"
  ],
  "landing_url": "https://doi.org/10.1111/apa.70685",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review Article"
    ],
    [
      "openalex",
      "2729|Maternal and Perinatal Health Interventions"
    ]
  ],
  "openalex": "W7169856594",
  "pdf_url": null,
  "pmcid": "PMC13747683",
  "pmid": "42478077",
  "published": "2026-07-20",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/c207yxsj11yh3.ris",
  "sources": [
    {
      "first_seen": "2026-11-12T12:23:42Z",
      "native_id": "PMC13747683",
      "source": "pmc",
      "url": "https://doi.org/10.1111/apa.70685"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2729|Maternal and Perinatal Health Interventions",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Maternal and Peri/Neonatal Mortality and Morbidity in Midwife‐Assisted Low‐Risk Birth Outside Hospital Compared to Obstetric Team‐Assisted Low‐Risk Hospital Birth: A Systematic Review and Meta‐Analysis",
  "title_text": "Maternal and Peri/Neonatal Mortality and Morbidity in Midwife‐Assisted Low‐Risk Birth Outside Hospital Compared to Obstetric Team‐Assisted Low‐Risk Hospital Birth: A Systematic Review and Meta‐Analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-13T12:24:51Z",
  "url": "https://research.draconitic.com/paper/c207yxsj11yh3",
  "venue": "Acta Paediatrica (Oslo, Norway : 1992)",
  "versions": []
}