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Alcaraz-Vidal L, Leon-Larios F, Robleda G, Vila-Candel R. Exploring home births in Catalonia (Spain): A cross-sectional study of women's experiences and influencing factors. J Adv Nurs 2024; 80:2363-2378. [PMID: 38012827 DOI: 10.1111/jan.15989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
AIM The study explores the experiences of women with low-risk pregnancies and no complications who planned a home birth. DESIGN A cross-sectional study was conducted using an online questionnaire. METHODS The questionnaire included socio-demographic, obstetric and perinatal variables. Birth satisfaction was evaluated via the Spanish version of the childbirth experience questionnaire. The study group comprised home-birthing women in Catalonia, Spain. Data were collected from 1 January 2019 to 31 December 2021. Statistical analysis was performed using SPSS. RESULTS A total of 236 women responded. They reported generally positive experiences, with professional support and involvement being the most highly rated dimensions. Better childbirth experiences were associated with labour lasting less than 12 h, no perineal injuries, no intrapartum transfers to hospital, euthocic delivery and the presence of a midwife. CONCLUSIONS Women's positive home birth experiences were linked to active participation and midwife support. Multiparous women felt safer. Medical interventions, especially transfers to hospitals, reduced satisfaction, highlighting the need for improved care during home births. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE Home births should be included among the birthplace options offered by public health services, given the extremely positive feedback reported by women who gave birth at home. IMPACT Home birth is not an option offered under Catalonia's public health system only as a private service. The experience of home-birthing women is unknown. This study shows a very positive birth experience due to greater participation and midwife support. The results help stakeholders assess home birth's public health inclusion and understand valued factors, supporting home-birthing women. REPORTING METHOD The study followed the STROBE checklist guidelines for cross-sectional studies. PUBLIC CONTRIBUTION Women who planned a home birth participated in the pilot test to validate the instrument, and their contributions were collected by the lead researcher. The questionnaire gathered the participants' email addresses, and a commitment was made to disseminate the study's results through this means.
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Affiliation(s)
- Lucia Alcaraz-Vidal
- Department of Obstetrics and Gynecology, University Hospital Germans Trias i Pujol, Badalona, Spain
- Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), Barcelona, Spain
- Catalan Association of Home Birth Midwives, Barcelona, Spain
| | - Fatima Leon-Larios
- Nursing Department. Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Sevilla, Spain
| | - Gemma Robleda
- Campus Docent Fundació Privada Sant Joan de Déu, School of Nursing, University of Barcelona, Barcelona, Spain
- Centro Cochrane Iberoamericano, Barcelona, Spain
| | - Rafael Vila-Candel
- Faculty of Health Sciences, International University of Valencia -VIU, Valencia, Spain
- Department of Primary Health, Foundation for Promoting of Health and Biomedical Research in the Valencian Region (FISABIO-SP), Valencia, Spain
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Migliorini L, Setola N, Naldi E, Rompianesi MC, Iannuzzi L, Cardinali P. Exploring the Role of Birth Environment on Italian Mothers' Emotional Experience during Childbirth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6529. [PMID: 37569069 PMCID: PMC10418452 DOI: 10.3390/ijerph20156529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023]
Abstract
The physical environment is one of the factors that affect mother's experience of childbirth and psychological health. A woman's childbirth experience has been found to influence not only the mother's own health and future births but also the well-being of her child and family. The present study's objective was to investigate mothers' perceptions of spatial-physical humanization, affective quality of place, and emotions during childbirth. To achieve this goal, the first part of our work was dedicated to selecting two birth environments (hospital and birth center) with different degrees of humanization. The methods include observations and field survey which mainly concerned the environmental quality of the spaces and the layout of the birth unit, and self-report questionnaire about perceived environment, affective quality attributed to place, and delivery experience. Participants are 66 low-risk women, choosing hospital or birth center. The findings indicate an enhanced perception of both the spatial-physical aspects and the social and functional aspects of the care unit among mothers who give birth at the birth center. These same mothers also report a more positive perception of the childbirth experience. In conclusion, this study contributes to the understanding of the role of birth environments in shaping mothers' emotional experiences during childbirth.
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Affiliation(s)
- Laura Migliorini
- Department of Education Sciences, University of Genoa, 16121 Genoa, Italy
| | - Nicoletta Setola
- Department of Architecture, University of Florence, 50121 Florence, Italy
| | - Eletta Naldi
- Department of Architecture, University of Florence, 50121 Florence, Italy
| | | | - Laura Iannuzzi
- Centre for Midwifery and Women’s Health, Bournemouth University, Bournemouth BH12 5BB, UK
| | - Paola Cardinali
- Department of Economics, Universitas Mercatorum, 00186 Rome, Italy
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Combellick JL, Telfer ML, Ibrahim BB, Novick G, Morelli EM, James-Conterelli S, Kennedy HP. Midwifery care during labor and birth in the United States. Am J Obstet Gynecol 2023; 228:S983-S993. [PMID: 37164503 DOI: 10.1016/j.ajog.2022.09.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 05/12/2023]
Abstract
The intrapartum period is a crucial time in the continuum of pregnancy and parenting. Events during this time are shaped by individuals' unique sociocultural and health characteristics and by their healthcare providers, practice protocols, and the physical environment in which care is delivered. Childbearing people in the United States have less opportunity for midwifery care than in other high-income countries. In the United States, there are 4 midwives for every 1000 live births, whereas, in most other high-income countries, there are between 30 and 70 midwives. Furthermore, these countries have lower maternal and neonatal mortality rates and have consistently lower costs of care. National and international evidences consistently report that births attended by midwives have fewer interventions, cesarean deliveries, preterm births, inductions of labor, and more vaginal births after cesarean delivery. In addition, midwifery care is consistently associated with respectful care and high patient satisfaction. Midwife-physician collaboration exists along a continuum, including births attended independently by midwives, births managed in consultation with a physician, and births attended primarily by a physician with a midwife acting as consultant on the normal aspects of care. This expert review defined midwifery care and provided an overview of midwifery in the United States with an emphasis on the intrapartum setting. Health outcomes associated with midwifery care, specific models of intrapartum care, and workforce issues have been presented within national and international contexts. Recommendations that align with the integration of midwifery have been suggested to improve national outcomes and reduce pregnancy-related disparities.
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Affiliation(s)
| | | | | | - Gina Novick
- Yale University School of Nursing, Orange, CT
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Madeley AM, Earle S, O'Dell L. Challenging norms: Making non-normative choices in childbearing. Results of a meta ethnographic review of the literature. Midwifery 2023; 116:103532. [PMID: 36371862 DOI: 10.1016/j.midw.2022.103532] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 10/08/2022] [Accepted: 10/28/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Women have the right to make choices during pregnancy and birth that sit outside clinical guidelines, medical recommendations, or normative expectations. Declining recommended place or mode of birth, routine intervention or screening can be considered 'non-normative' within western cultural and social expectations around pregnancy and childbirth. The aim of this review is to establish what is known about the experiences, views, and perceptions of women who make non-normative choices during pregnancy and childbirth to uncover new understandings, conceptualisations, and theories within existing literature. METHODS Using the meta-ethnographic method, and following its seven canonical stages, a systematic search of databases was performed, informed by eMERGe guidelines. FINDINGS Thirty-three studies met the inclusion criteria. Reciprocal translation resulted in three third order constructs - 'influences and motivators', 'barriers and conflict and 'knowledge as empowerment'. Refutational translation resulted in one third order construct - 'the middle ground', which informed the line of argument synthesis and theoretical insights. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The findings of this review suggest that whilst existing literature from a range of high-income countries with similar healthcare systems to the UK have begun to explore non-normative decision-making for discrete episodes of care and choices, knowledge based, theoretical and population gaps exist in relation to understanding the experiences of, and wider social processes involved in, making non-normative choices across the UK maternity care continuum.
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Affiliation(s)
- Anna-Marie Madeley
- Faculty of Wellbeing, Education and Language Studies, The Open University, Walton Hall, Milton Keynes, MK7 6AA, United Kingdom.
| | - Sarah Earle
- Graduate School: Research, Enterprise & Scholarship, The Open University, Walton Hall, Milton Keynes MK7 6AA, United Kingdom
| | - Lindsay O'Dell
- School of Nursing and Health Education, University of Bedfordshire, University Square, Luton LU1 3JU, United Kingdom
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Galera-Barbero TM, Aguilera-Manrique G. Women's reasons and motivations around planning a home birth with a qualified midwife in Spain. J Adv Nurs 2022; 78:2608-2621. [PMID: 35301770 DOI: 10.1111/jan.15225] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/15/2022] [Accepted: 02/13/2022] [Indexed: 12/01/2022]
Abstract
AIMS The aim of this study was to describe and understand the reasons and motivations that lead a woman to choose home birth in Spain. DESIGN A qualitative study based on Gadamer's hermeneutic phenomenology was carried out. METHODS In-depth interviews were conducted with 24 women who had planned a home birth in the last year. The recruitment phase was carried out over a 3-week period during the month of March 2021. Inductive analysis was used to find themes based on the data obtained. RESULTS Four main themes emerged from the data analysis: (1) Women's home birth decision making, (2) Partner as the main support, (3) Need to prepare for childbirth and (4) Reasons for choosing home birth. CONCLUSION The women in this study spent a lot of time and dedication to choose the place where they would give birth. According to this research, decision making is influenced by multiple factors, both positive and negative, such as women's individual beliefs and values. The main reasons why women chose a home birth were the intimacy and security of the home, the accompaniment and the desire for a natural and free birth. IMPACT This study adds knowledge about the factors that influence the decision of women who choose home birth in Spain and the reasons and motivations that lead them to do so. In addition, it raises new questions about the satisfaction of women giving birth in the hospital as well as outside the hospital, and the quality of service provided by health professionals in the current Spanish public maternity system.
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Affiliation(s)
- Trinidad María Galera-Barbero
- Midwife of the Spanish National Health, Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, Almería, Spain
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Galera-Barbero TM, Aguilera-Manrique G. Experience, perceptions and attitudes of parents who planned home birth in Spain: A qualitative study. Women Birth 2022; 35:602-611. [DOI: 10.1016/j.wombi.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/10/2022] [Accepted: 01/10/2022] [Indexed: 10/19/2022]
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Blums T, Donnellan-Fernandez R, Sweet L. Women's perceptions of inclusion and exclusion criteria for publicly-funded homebirth - A survey. Women Birth 2021; 35:413-422. [PMID: 34518118 DOI: 10.1016/j.wombi.2021.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND There are 15 publicly-funded homebirth programs in Australia. Women's access to these programs is determined by program specific inclusion and exclusion criteria. AIMS To examine women's perception of inclusion and exclusion criteria for publicly-funded homebirth programs in Australia and how these perceptions may influence women's choices and access to these programs. METHODS A national online survey was conducted and promoted through social media networks to women interested in homebirth in Australia. Quantitative data were analysed to generate descriptive statistics and a content analysis was performed on qualitative data. FINDINGS A total of 830 surveys were collected. Most women were supportive of inclusion and exclusion criteria related to social and environmental factors, although there was ambivalence about requiring ambulance cover, not having a history of domestic violence in the current relationship and requiring the woman to speak basic English. With regards to obstetric factors, only a requirement for labour to commence spontaneously at term was supported by over half of participants. All other obstetric related criteria had over half of participants disagreeing or strongly disagreeing that they should be used to prevent a woman from birthing at home. A desire for choice and access was frequently mentioned in the qualitative data. CONCLUSION There is a need to address the lack of choice many women experience when pregnant and the lack of equitable access to affordable homebirth services in Australia.
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Affiliation(s)
- Tija Blums
- School of Nursing and Midwifery, Griffith University, Australia; Western Health, St Albans, VIC, Australia.
| | - Roslyn Donnellan-Fernandez
- School of Nursing and Midwifery, Griffith University, Australia; Transforming Maternity Care Collaborative, Australia. https://twitter.com/@RozDFernandez
| | - Linda Sweet
- Western Health, St Albans, VIC, Australia; School of Nursing & Midwifery, Faculty of Health, Deakin University, Australia. https://twitter.com/@ProfLindaSweet
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Russell K, Manias E, Nicholson P. What influences rural women's choices in maternity care: A qualitative exploratory study. Nurs Health Sci 2021; 23:825-833. [PMID: 34245099 DOI: 10.1111/nhs.12867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 11/29/2022]
Abstract
Rural women are likely to experience difficulties accessing maternity care that is readily available in metropolitan areas. This limited access can impede women's ability to make informed choices that enhance safety and minimize harm. This study explored the experiences of women who had given birth in a rural environment and the factors that influenced their choices regarding their maternity care. Semistructured interviews were conducted with 10 women for this qualitative, exploratory study. These women had birthed within rural areas of Victoria, Australia, between May 2016 and May 2017. Thematic analysis was undertaken. Three main themes emerged: (i) being influenced by previous childbirth experiences, (ii) feeling safe and supported with their maternity care provider, and (iii) being supported in their birthing choices. The availability of maternity care providers and travel time to facilities limited the choices of rural women. This study provided valuable insights into what was behind the decisions of rural women's choices regarding their maternity care. To assist with making informed decisions regarding their maternity care, all available models of maternity care should be presented to rural women.
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Affiliation(s)
- Kristie Russell
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Elizabeth Manias
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Patricia Nicholson
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, VIC, Australia
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Alcaraz-Vidal L, Escuriet R, Sàrries Zgonc I, Robleda G. Planned homebirth in Catalonia (Spain): A descriptive study. Midwifery 2021; 98:102977. [PMID: 33751929 DOI: 10.1016/j.midw.2021.102977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/17/2021] [Accepted: 03/01/2021] [Indexed: 12/23/2022]
Affiliation(s)
- L Alcaraz-Vidal
- PhD candidate, Biomedicine Programme, Department of Experimental and Health Sciences, University Pompeu Fabra. Barcelona, Spain; Midwife Coordinator Birth Centre Project, Germans Trias i Pujol Hospital, Carretera del Canyet S/N 08, Badalona, Spain; Sexual and Reproductive Health Research Group, (GRASSIR), Catalan Health Institute Barcelona, Spain; Catalan Association of Homebirth Midwives, Spain.
| | - R Escuriet
- Faculty of Health Sciences, Universitat Ramon Llull. Global Health Gender and Society (GHenderS) Research Group. Barcelona, Spain; Catalan Health Service. Government of Catalonia, Spain
| | - I Sàrries Zgonc
- Catalan Association of Homebirth Midwives, Spain; Independent RM, Spain
| | - G Robleda
- Campus Docent Fundació Privada Sant Joan de Déu, School of Nursing, University of Barcelona. Spain; Iberoamerican Cochrane Centre. Barcelona, Spain
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Abstract
OBJECTIVE To explore the decision-making processes of women who planned home births and to generate an emerging theoretical description of these processes. DESIGN Qualitative descriptive study using grounded theory. SETTING A certified nurse-midwifery home birth practice in a midsized city in the United States. PARTICIPANTS Eleven adult women who planned home births with certified nurse-midwives. METHODS We conducted semistructured, in-depth interviews with participants to discuss their decision-making processes regarding planning for their home births. Interviews were recorded and transcribed verbatim. We used open, selective, and theoretical coding and constant comparison to analyze the data. RESULTS The core category in the decision-making process regarding home birth was Claiming Maternal Space. The three main themes under this core category were Awareness of home birth, Movement from conventional perinatal care, and Shelter Building for labor and birth. CONCLUSION Our results suggest that women who plan home births greatly value agency during perinatal care. The core category Claiming Maternal Space represented how participants solved the problem of decreased agency in conventional perinatal care. Further research is needed to validate the emerging theoretical description and explore the association between agency and perinatal outcomes.
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Ziogou R, Zografou K. Homebirth and homecare during COVID-19. Eur J Midwifery 2020; 4:14. [PMID: 33537616 PMCID: PMC7839141 DOI: 10.18332/ejm/120972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 01/11/2023] Open
Affiliation(s)
- Revekka Ziogou
- National Public Health Organization-PHILOS, Refugee Center, Alexandria, Greece
| | - Katerina Zografou
- Department of High-Risk Pregnancies and Postpartum Ward, General University Hospital of Patras, Patra, Greece
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