Home Versus Hospital Birth—Process and Outcome

Wax, Joseph R.; Pinette, Michael G.; Cartin, Angelina

doi:10.1097/ogx.0b013e3181d0fe5d

Cited by 20 publications

(22 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…33 The difference between the base rates of 0.4 and 1.7 perinatal deaths per 1000 births goes some way towards explaining the Wax et al finding of a tripled risk. 46 The Wax et al 46 study has generated findings that have been challenged on several points. The first point concerns the comparison of home birth outcomes between countries that vary in culture, geography and healthcare systems.…”

Section: Discussionmentioning

confidence: 99%

“…29 Wax et al undertook a meta-analysis of perinatal mortality in planned home births compared with planned hospital births. 46 The study included 12 studies from seven western countries reporting that less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate. The study's findings are based on a standard perinatal mortality rate of 0.4 deaths per 1000 births for term infants in the absence of congenital abnormality.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Safety of non-medically led primary maternity care models: a critical review of the international literature

McIntyre¹

2012

Aust. Health Review

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Safety of non-medically led primary maternity care models: a critical review of the international literature

McIntyre¹

2012

Aust. Health Review

View full text Add to dashboard Cite

show abstract

“…To date this interest has mainly been incidental to other concerns, such as women's choice of place of birth 21 or the development of midwife-led services outside OUs. [22][23][24][25][26] Other work in this area has focused on midwives rather than women and explored the effects on midwives of working in the community 19,27 or in midwife-led units [28][29][30] rather than in consultant-led units. In addition, much of the wider work in health care that has explored problems of space and place has done so while focusing on workplace relationships, for example health-care professionals' relationships with managers 31 and midwives' relationships with junior doctors 32 and support staff.…”

Section: Development Of Birth Centresmentioning

confidence: 99%

An ethnographic organisational study of alongside midwifery units: a follow-on study from the Birthplace in England programme

McCourt

Rayment

Rance

et al. 2014

Health Services and Delivery Research

View full text Add to dashboard Cite

BackgroundAlongside midwifery units (AMUs) were identified as a novel hybrid organisational form in the Birthplace in England Research Programme, to which this is a follow-on study. The number of such units (also known as hospital birth centres) has increased greatly in the UK since 2007. They provide midwife-led care to low-risk women adjacent to maternity units run by obstetricians, aiming to provide a homely environment to support normal childbirth. Women are transferred to the obstetric unit (OU) if they want an epidural or if complications occur.AimsThis study aimed to investigate the ways that AMUs in England are organised, staffed and managed. It also aimed to look at the experiences of women receiving maternity care in an AMU and the views and experiences of maternity staff, including both those who work in an AMU and those in the adjacent OU.MethodsAn organisational ethnography approach was used, incorporating case studies of four AMUs, selected for maximum variation on the basis of geographical context, length of establishment of an AMU, size of unit, management, leadership and physical design. Interviews were conducted between December 2011 and October 2012 with service managers and key stakeholders (n = 35), with professionals working within and in relation to AMUs (n = 54) and with postnatal women and birth partners (n = 47). Observations were conducted of key decision-making points in the service (n = 20) and relevant service documents and guidelines were collected and reviewed.FindingsWomen and their families valued AMU care highly for its relaxed and comfortable environment, in which they felt cared for and valued, and for its support for normal birth. However, key points of transition for women could pose threats to equity of access and quality of their care, such as information and preparation for AMU care, and gaining admission in labour and transfer out of the unit. Midwives working in AMUs highly valued the environment, approach and the opportunity to exercise greater professional autonomy, but relations between units could also be experienced as problematic and as threats to professional autonomy as well as to quality and safety of care. We identified key themes that pose potential challenges for the quality, safety and sustainability of AMU care: boundary work and management, professional issues, staffing models and relationships, skills and confidence, and information and access for women.ConclusionsAMUs have a role to play in contributing to service quality and safety. They provide care that is satisfying for women, their partners and families and for health professionals, and they facilitate appropriate care pathways and professional roles and skills. There is a potential for AMUs to provide equitable access to midwife-led care when midwifery unit care is the default option (opt-out) for all healthy women. The Birthplace in England study indicated that AMUs provide safe and cost-effective care. However, the opportunity to plan to birth in an AMU is not yet available to all eligible women, and is often an opt-in service, which may limit access. The alignment of physical, philosophical and professional boundaries is inherent in the rationale for AMU provision, but poses challenges for managing the service to ensure key safety features of quality and safety are maintained. We discuss some key issues that may be relevant to managers in seeking to respond to such challenges, including professional education, inter- and intraprofessional communication, relationships and teamwork, integrated models of midwifery and women’s care pathways. Further work is recommended to examine approaches to scaling up of midwifery unit provision, including staffing and support models. Research is also recommended on how to support women effectively in early labour and on provision of evidence-based and supportive information for women.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

show abstract

“…As a result of this distrust most African Americans are seeking the spiritual and cultural rituals of the African culture (Ngomane and Mulaudzi, 2010). Finally, in our study, the most pertinent factors identified by African American women who desired a home birth were the desire to have control, avoiding pharmacological pain relief, and dissatisfaction with the medical aspects of intrapartum care (Wax et al, 2010;Ngomane and Mulaudzi, 2010;Draper, 2002). The aforementioned are the focus of our literature review.…”

Section: An Afrocentric/africentric Sociological Approachmentioning

confidence: 87%

A Qualitative Examination of Factors that Influence Birthing Options for African American Women

Farrish

Robertson

2012

Critical Sociology

View full text Add to dashboard Cite

This article examines the factors that influenced the birthing decisions of a group of African American women from regions throughout the United States who selected to give birth at home. Using the Afrocentric and Africentric social science models developed by Asante and Akbar, respectively, 25 African American women were interviewed to discern why they chose to give birth at home and eschew traditional Western medical birthing practices. The women asserted that (1) a desire for control, (2) avoiding pharmacological pain relief, and (3) dissatisfaction with the medical aspects of intrapartum care were all central in their decision-making process. Finally, the participants also alluded to a desire to utilize indigenous African birthing methods and to reconnect with more indigenous African cultural practices.

show abstract

Home Versus Hospital Birth—Process and Outcome

Cited by 20 publications

References 37 publications

Safety of non-medically led primary maternity care models: a critical review of the international literature

Safety of non-medically led primary maternity care models: a critical review of the international literature

An ethnographic organisational study of alongside midwifery units: a follow-on study from the Birthplace in England programme

A Qualitative Examination of Factors that Influence Birthing Options for African American Women

Contact Info

Product

Resources

About