Under scrutiny: Midwives' experience of intrapartum transfer from home to hospital within the context of a planned homebirth in Western Australia

Ball, Colleen; Hauck, Yvonne; Kuliukas, Lesley; Lewis, Lucy; Doherty, Dorota A.

doi:10.1016/j.srhc.2016.02.009

Cited by 12 publications

(8 citation statements)

References 16 publications

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“…Understanding why this is the case is needed. A recent survey of intrapartum transfers with 13 Australian midwives identified barriers to timely transfer of women to hospital [23]. Midwives reported health services either refusing to accept transfers or health services/hospital staff being hostile to the midwives when they arrived [23].…”

Section: Discussionmentioning

confidence: 99%

“…A recent survey of intrapartum transfers with 13 Australian midwives identified barriers to timely transfer of women to hospital [23]. Midwives reported health services either refusing to accept transfers or health services/hospital staff being hostile to the midwives when they arrived [23]. This was in contrast to experiences some of these midwives had when they worked as a homebirth midwife in the UK [23].…”

Section: Discussionmentioning

confidence: 99%

“…Midwives reported health services either refusing to accept transfers or health services/hospital staff being hostile to the midwives when they arrived [23]. This was in contrast to experiences some of these midwives had when they worked as a homebirth midwife in the UK [23]. The rate of homebirth in Australia is much lower than the rest of the world.…”

Section: Discussionmentioning

confidence: 99%

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Planned private homebirth in Victoria 2000–2015: a retrospective cohort study of Victorian perinatal data

Davies‐Tuck

Wallace

Davey

et al. 2018

BMC Pregnancy Childbirth

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BackgroundThe outcomes for planned homebirth in Victoria are unknown. We aimed to compare the rates of outcomes for high risk and low risk women who planned to birth at home compared to those who planned to birth in hospital.MethodsWe undertook a population based cohort study of all births in Victoria, Australia 2000–2015. Women were defined as being of low or high risk of adverse pregnancy outcomes according to the eligibility criteria for homebirth and either planning to birth at home or in a hospital setting at the at the onset of labour. Rates of perinatal and maternal mortality and morbidity as well as obstetric interventions were compared.ResultsThree thousand nine hundred forty-five women planned to give birth at home with a privately practising midwife and 829,286 women planned to give birth in a hospital setting. Regardless of risk status, planned homebirth was associated with significantly lower rates of all obstetric interventions and higher rates of spontaneous vaginal birth (p ≤ 0.0001 for all). For low risk women the rates of perinatal mortality were similar (1.6 per 1000 v’s 1.7 per 1000; p = 0.90) and overall composite perinatal (3.6% v’s 13.4%; p ≤ 0.001) and maternal morbidities (10.7% v’s 17.3%; p ≤ 0.001) were significantly lower for those planning a homebirth. Planned homebirth among high risk women was associated with significantly higher rates of perinatal mortality (9.3 per 1000 v’s 3.5 per 1000; p = 0.009) but an overall significant decrease in composite perinatal (7.8% v’s 16.9%; p ≤ 0.001) and maternal morbidities (16.7% v’s 24.6%; p ≤ 0.001).ConclusionRegardless of risk status, planned homebirth was associated with significantly lower rates of obstetric interventions and combined overall maternal and perinatal morbidities. For low risk women, planned homebirth was also associated with similar risks of perinatal mortality, however for women with recognized risk factors, planned homebirth was associated with significantly higher rates of perinatal mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Planned private homebirth in Victoria 2000–2015: a retrospective cohort study of Victorian perinatal data

Davies‐Tuck

Wallace

Davey

et al. 2018

BMC Pregnancy Childbirth

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“…Her access to the hospital may depend upon both her credentials (Vedam, Goff & Marnin 2007) and her relationships with hospital staff (Dahlen 2012;Foley & Faircloth 2003;McCourt et al 2012;Vedam et al 2014). The significance of this is that the ability of the homebirth midwife to provide continuity of care throughout the transfer and into the hospital setting is important, both to women (Fox, Sheehan & Homer 2014) and to homebirth midwives (Ball et al 2016; The aim of this study was to explore the processes and interactions that occur during transfer from the perspectives of women, midwives and obstetricians involved in the intrapartum transfer of a woman from a planned homebirth to hospital.…”

Section: Maternity Services In Australiamentioning

confidence: 99%

Birthplace in Australia: Processes and interactions during the intrapartum transfer of women from planned homebirth to hospital

2018

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the midwife-woman partnership played a central role in providing the necessary support and advocacy for women transferred out of their comfort zone. When midwives worked together in an integrated system to provide the necessary care and support for women who were transferred, greater levels of collaboration emerged and women's perceptions of their quality of care was high. In practice, this meant health professionals respecting each other's roles, responsibilities and expertise, and ameliorating 'us and them' dynamics.

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“…Intrapartalen Verlegungen geht immer ein gründlicher Entscheidungsprozess voraus. Dieser wird nicht nur durch Überlegungen zum optimalenZeitpunktbeeinflusst,sondernauchvonderwahrgenommenen Willkommenskultur in der Klinik und der Möglichkeit zur Fortführung der kontinuierlichen Betreuung [8,45].…”

Section: Introductionunclassified

Outcomes geplanter außerklinischer und klinischer Low-Risk Geburten in Niedersachsen

Petersen

Köhler

Schwarz

et al. 2017

Z Geburtshilfe Neonatol

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Internationally, there is debate on the safety of different birth settings inside and outside of hospitals. Low-risk women in Germany can choose where they give birth, and out-of-hospital births are especially necessary in regions lacking infrastructure. To date, national studies are required. We investigated planned out-of-hospital (OH) and hospital births in Lower Saxony, Germany, in 2005. Women with a singleton fetus in the vertex position were included once they reached 34+0 gestational weeks. 1 273 out of 4 424 births were included via risk assessment. Outcomes were compared using Pearson's chi-squared test, the Mann-Whitney test, and logistic regression. 152 (36.6%) nulliparae (NP) and 263 (63.4%) multiparae (MP) gave birth out of hospital, 439 (51.2%) nulliparae and 419 (48.8%) multiparae in a hospital. 10.1% of women whose care started outside of the hospital needed a transfer to the hospital. Women who planned OH were older and had a higher level of education. Women without a migration background displayed an increased rate of out-of-hospital birth. A higher proportion received their antenatal care from midwives rather than medical doctors. Induction of labor was less likely for women with planned out-of-hospital births, as were other intrapartum interventions. In hospital births, fetal monitoring was more likely performed via cardiotocograph instead of intermittent auscultation. Duration of labor was significantly longer in OH births (median: NP: 9.01 h vs. 7.38 h; MP: 4.53 h vs. 4.25 h). Nulliparae had more spontaneous births out-of-hospital (94.7%) than in hospital (73.6%). There was no difference in adverse fetal outcomes, blood loss, and severe perineal lacerations. The perineum was less frequently intact in hospital births. Retained placenta was more often documented in out-of-hospital births. In an out-of-hospital setting, fewer interventions were performed, spontaneous births occurred more often, and there was no difference in neonatal outcomes. OH birth appears reasonably safe with thorough pre-labor risk assessment and good transfer management. Some beneficial aspects of OH birth care (like continuity of care and restriction of routine interventions) could be adopted by hospital labor wards, leading to a higher rate of vaginal births and improved care.

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Under scrutiny: Midwives' experience of intrapartum transfer from home to hospital within the context of a planned homebirth in Western Australia

Cited by 12 publications

References 16 publications

Planned private homebirth in Victoria 2000–2015: a retrospective cohort study of Victorian perinatal data

Planned private homebirth in Victoria 2000–2015: a retrospective cohort study of Victorian perinatal data

Birthplace in Australia: Processes and interactions during the intrapartum transfer of women from planned homebirth to hospital

Outcomes geplanter außerklinischer und klinischer Low-Risk Geburten in Niedersachsen

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