Comparison 1. Alternative versus conventional birth settings ‐ all trials.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 No analgesia/anesthesia	6	8953	Risk Ratio (IV, Fixed, 95% CI)	1.18 [1.05, 1.33]
2 Oxytocin augmentation of labour	8	11131	Risk Ratio (IV, Random, 95% CI)	0.77 [0.67, 0.88]
3 Epidural analgesia	8	10931	Risk Ratio (IV, Fixed, 95% CI)	0.80 [0.74, 0.87]
4 Instrumental vaginal birth (forceps or ventouse)	8	11202	Risk Ratio (IV, Fixed, 95% CI)	0.89 [0.79, 0.99]
5 Caesarean birth	9	11350	Risk Ratio (IV, Fixed, 95% CI)	0.88 [0.78, 1.00]
6 Spontaneous vaginal birth	8	11202	Risk Ratio (IV, Fixed, 95% CI)	1.03 [1.01, 1.05]
7 Episiotomy	8	11055	Risk Ratio (IV, Fixed, 95% CI)	0.83 [0.77, 0.90]
8 Postpartum hemorrhage	6	10712	Risk Ratio (IV, Fixed, 95% CI)	0.94 [0.82, 1.08]
9 5‐minute Apgar score < 7	7	7665	Risk Ratio (IV, Fixed, 95% CI)	0.98 [0.70, 1.38]
10 Admission to neonatal intensive care unit	7	10978	Risk Ratio (IV, Fixed, 95% CI)	1.09 [0.94, 1.26]
11 Serious perinatal morbidity or mortality	5	6385	Risk Ratio (IV, Random, 95% CI)	1.17 [0.51, 2.67]
12 Perinatal mortality	8	11206	Risk Ratio (IV, Fixed, 95% CI)	1.67 [0.93, 3.00]
13 Serious maternal morbidity or mortality	4	6334	Risk Ratio (IV, Fixed, 95% CI)	1.11 [0.23, 5.36]
14 Breastfeeding at 6‐8 weeks	1	1147	Risk Ratio (IV, Fixed, 95% CI)	1.04 [1.02, 1.06]
15 Very positive views of care	2	1207	Risk Ratio (IV, Fixed, 95% CI)	1.96 [1.78, 2.15]