1
|
Crockett AK, Laden BF, Tumin D, Whiteside JL. Predictors of planned home birth before and during the COVID-19 pandemic. J Perinat Med 2024; 52:283-287. [PMID: 38296773 DOI: 10.1515/jpm-2023-0439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVES To determine how demographic and clinical predictors of home birth have changed since the onset of the COVID-19 pandemic in the US. METHODS Using National Vital Statistics birth certificate data, a retrospective population-based cohort study was performed with planned home births and hospital births among women age ≥18 years during calendar years 2019 (pre-pandemic) and 2021 (pandemic-era). Birth location (planned home birth vs. hospital birth) was analyzed using univariate and multivariable logistic regression, systematically examining the interaction of each demographic and clinical covariate with study year. RESULTS After exclusions, a total of 6,087,768 birth records were retained for analysis, with the proportion of home births increasing from 0.82 % in 2019 to 1.24 % in 2021 (p<0.001). In the final multivariable logistic regression model of planned home birth, five demographic variables retained a statistically significant interaction with year: race and ethnicity, age, educational attainment, parity, and WIC participation. In each case, demographic differences between those having planned home births and hospital births became smaller (odds ratios closer to 1) in 2021 compared to 2019. CONCLUSIONS Planned home births increased by more than 50 % during the pandemic, with greater socioeconomic diversity in the pandemic-era home birth cohort. The presence of clinical risk factors remained a strong predictor of hospital birth, with no evidence that pandemic-era home births had a higher clinical risk profile as compared to the pre-pandemic period.
Collapse
Affiliation(s)
- Allison K Crockett
- Department of Obstetrics and Gynecology, Brody School of Medicine, East Carolina University, Greenville, NC, USA
- Department of Obstetrics and Gynecology, University of Florida College of Medicine - Jacksonville, Jacksonville, FL, USA
| | - Bethany F Laden
- Department of Obstetrics and Gynecology, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Dmitry Tumin
- Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - James L Whiteside
- Department of Obstetrics and Gynecology, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| |
Collapse
|
2
|
Holdren S, Crook L, Lyerly A. Birth setting decisions during COVID-19: A comparative qualitative study. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241227363. [PMID: 38282515 PMCID: PMC10826375 DOI: 10.1177/17455057241227363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/08/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND The COVID-19 pandemic resulted in an increased number of out-of-hospital births in the United States and other nations. While many studies have sought to understand the experiences of pregnant and birthing people during this time, few have compared experiences across birth locations. OBJECTIVE The purpose of this study is to compare the narratives and decision-making processes of those who gave birth in and out of hospitals during the pandemic. DESIGN We conducted semi-structured narrative interviews with 24 women who gave birth during the COVID-19 pandemic. METHODS Interviews were transcribed and coded, and a thematic narrative analysis was employed. Final themes and exemplary quotes were determined in discussion among the research team. RESULTS Results from narrative analysis revealed three themes that played into participants' birth location decisions: (1) birth efficacy and values, (2) diverse definitions of safety, and (3) childcare and other logistics. In each of these themes, participants who gave birth in birthing centers, at the hospital, and at home describe their individualized approach to achieving a supportive birth environment while mitigating the risk of labor complications and COVID-19 infection. CONCLUSION Our study suggests that for some childbearing people, the pandemic did not change birthing values or decisions but rather brought enhanced clarity to their individual needs during birth and perceived risks, benefits, and limitations of each birthing space. This study further highlights the need for improved structural support for birthing people to access a range of safe and supportive birthing environments.
Collapse
Affiliation(s)
- Sarah Holdren
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Laura Crook
- Department of English and Comparative Literature, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anne Lyerly
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| |
Collapse
|
3
|
Higgins DM, Haynes AL, Jensen JC, O'Leary ST, Moss A, Calonge N. Planned Out-of-Hospital Birth as a Risk Factor for Nonreceipt of Hepatitis B Immunization. Pediatr Infect Dis J 2023; 42:819-823. [PMID: 37310892 DOI: 10.1097/inf.0000000000003992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The hepatitis B vaccine (HBV) is recommended at birth to prevent perinatal hepatitis B transmission; however, many newborns still do not receive HBV. The extent to which planned out-of-hospital births, which have increased over the past decade, are associated with nonreceipt of the HBV birth dose is unknown. The purpose of this study was to determine whether a planned out-of-hospital birth location is associated with the nonreceipt of the HBV birth dose. METHODS We performed a retrospective cohort study of all births from 2007 to 2019 recorded in the Colorado birth registry. χ2 analyses were used to compare maternal demographics by birth location. Univariate and multiple logistic regression were used to evaluate the association of birth location with nonreceipt of the HBV birth dose. RESULTS In total 1.5% of neonates born in freestanding birth centers and 0.1% of neonates born at a planned home birth received HBV compared to 76.3% of neonates born in a hospital location. After adjusting for confounders, this translated to a large increase in the odds of not receiving HBV compared to in-hospital births [freestanding birth center (aodds ratio (aOR): 172.98, 95% confidence interval (CI): 136.98-219.88); planned home birth (aOR: 502.05, 95% CI: 363.04-694.29)]. Additionally, older maternal age, White/non-Hispanic race and ethnicity, higher income, and private or no insurance were associated with nonreceipt of the HBV birth dose. CONCLUSIONS Planned out-of-hospital birth is a risk factor for nonreceipt of the HBV birth dose. As births in these locations become more common, targeted policies and education are warranted.
Collapse
Affiliation(s)
- David M Higgins
- From the Department of Epidemiology, Colorado School of Public Health, Aurora, CO
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
- Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado/Children's Hospital Colorado, Aurora, CO
| | - Allison L Haynes
- From the Department of Epidemiology, Colorado School of Public Health, Aurora, CO
| | - Julia C Jensen
- From the Department of Epidemiology, Colorado School of Public Health, Aurora, CO
| | - Sean T O'Leary
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Angela Moss
- Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado/Children's Hospital Colorado, Aurora, CO
| | - Ned Calonge
- From the Department of Epidemiology, Colorado School of Public Health, Aurora, CO
| |
Collapse
|
4
|
Watanabe A, Inoue S, Okatsu A, Eto H, Oguro M, Kataoka Y. Complementary and alternative medicine use by pregnant women in Japan: a pilot survey. BMC Complement Med Ther 2023; 23:298. [PMID: 37620968 PMCID: PMC10464089 DOI: 10.1186/s12906-023-04126-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/14/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Complementary and alternative medicine (CAM) are popular among women, and are used during their pregnancy in Japan. This study aimed to survey the prevalence of CAM use by healthy pregnant women as a health-care prescribed therapy or self-care and to investigate the factors associated with CAM use in Japan. METHODS In this cross-sectional study, pregnant women after 34 weeks of gestation were asked to respond to a questionnaire at the clinic or online. The questionnaire comprised questions on the participants' characteristics and their use of CAM for therapy and self-care. Descriptive statistics were calculated in the analyses, and bivariate and multivariate logistic analyses were performed to evaluate the associations between factors and CAM use. RESULTS A total of 394 women responded from three hospitals, two clinics, and two midwifery birth centers. CAM was received as treatment by practitioners during pregnancy by 75 women (19.0%). The following therapies were used: traditional Chinese medicine (7.9%), chiropractic (6.9%), moxibustion (6.4%), and acupuncture (5.3%). One or more types of therapy were used as self-care by 348 women (88.3%). Highly used CAM for self-care were: folic acid supplementation (75.4%), other supplements (51.5%), herbs (20.8%), and yoga (19.0%). Multiple logistic regression analyses revealed that the factors associated with CAM use as a therapy were midwifery birth centers for planned childbirth settings (adjusted odds ratio [AOR] 3.64, 95% confidence interval [CI] [1.69-7.83]) and pregnancy complications diagnosed (AOR 2.46, 95%CI [1.38-4.39]). The factors associated with CAM use for self-care were age 30-39 years (AOR 4.48, 95%CI [2.14-9.73]) and over 40 years (AOR 3.92, 95%CI [1.10-13.91]), junior college education or above (AOR 2.30, 95%CI [1.18-4.51]), and primiparas (AOR 3.82, 95%CI [1.86-7.86]). The most common source of information was the "Internet" (43.8%). CONCLUSIONS Approximately 20% of Japanese pregnant women received CAM as therapy by practitioners, and the related factors were: tended to have baby at midwifery birth center and pregnancy complications. Almost 90% of respondents used CAM as self-care and the related factors were: older, had a higher educational level and tended to be primiparas. They used the Internet as their main source of information about CAM. Health care providers need to provide evidenced-based information on CAM and to help decision making to ensure safe and effective CAM utilization by pregnant women.
Collapse
Affiliation(s)
- Ayana Watanabe
- St. Luke's International Hospital, 9-1 Akashi-Cho, Tokyo, 104-8560, Japan
| | - Satomi Inoue
- St. Luke's International University, 10-1, Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Aiko Okatsu
- Japanese Red Cross Toyota College of Nursing, 12-33 Nanamagari, Hakusan-Cho, Toyota, Aichi, 471-8565, Japan
| | - Hiromi Eto
- Nagasaki University, Institute of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan
| | - Michiko Oguro
- Tokyo Healthcare University, 1-1042-2 Kaijincho Nishi, Funabashi City, Chiba, 273-8710, Japan
| | - Yaeko Kataoka
- St. Luke's International University, 10-1, Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan.
| |
Collapse
|
5
|
Širvinskienė G, Grincevičienė Š, Pranskevičiūtė‐Amoson R, Kukulskienė M, Downe S. 'To be Informed and Involved': Women's insights on optimising childbirth care in Lithuania. Health Expect 2023; 26:1514-1523. [PMID: 37282753 PMCID: PMC10349258 DOI: 10.1111/hex.13754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/14/2022] [Accepted: 03/03/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION The user expectations and experiences of healthcare services are acknowledged as components of the quality of healthcare evaluations. The aim of the study is to analyse women's experiences and views on childbirth care in Lithuania. METHODS The study used the Babies Born Better (B3) online survey as the data collection instrument. The B3 is an ongoing longitudinal international project, examining the experiences of intrapartum care and developed as part of EU-funded COST Actions (IS0907 and IS1405). Responses to open-ended questions about (1) the best things about the care and (2) things in childbirth care worth changing are included in the current analysis. The participants are 373 women who had given birth within 5 years in Lithuania. A deductive coding framework established by the literature review was used to analyse the qualitative data. The framework involves three main categories: (1) the service, (2) the emotional experience and (3) the individually experienced care, each further divided into subcategories. RESULTS Reflecting the experience and views regarding the service at birthplace women wished empowerment, support for their autonomy and to be actively involved in decisions, the need for privacy, information and counselling, especially about breastfeeding. In terms of emotional experience, women highlighted the importance of comprehensibility/feeling of safety, positive manageability of various situations and possibilities for bonding with the newborn. Individually experienced care was described by feedback on specific characteristics of care providers, such as competence, personality traits, time/availability and encouragement of esteem in women in childbirth. The possibilities of homebirth were also discussed. The findings reflected salutogenic principles. KEY CONCLUSIONS The findings suggest that the Lithuanian healthcare system is in a transition from paternalistic attitude-based practices to a shift towards patient-oriented care. Implementation of the improvements suggested for women in childbirth care in Lithuania would require some additional services, improved emotional and intrapersonal aspects of care and a more active role for women. PATIENT/PUBLIC CONTRIBUTION Patients and the public contributed to this study by spreading information about surveys and research findings through their involvement in service user groups that have an interest in maternity care. Members of the patients' groups and the public were involved in the discussion of the results.
Collapse
Affiliation(s)
- Giedrė Širvinskienė
- Department of Health Psychology, Faculty of Public HealthLithuanian University of Health SciencesKaunasLithuania
- Health Research Institute, Faculty of Public HealthLithuanian University of Health SciencesKaunasLithuania
| | - Švitrigailė Grincevičienė
- Department of Biothermodynamics and Drug Design, Institute of Biotechnology, Life Science CentreVilnius UniversityVilniusLithuania
| | | | - Milda Kukulskienė
- Department of Health Psychology, Faculty of Public HealthLithuanian University of Health SciencesKaunasLithuania
| | - Soo Downe
- ReaCH Group, THRIVE CentreUniversity of Central LancasterPrestonUK
| |
Collapse
|
6
|
Danhausen K, Diaz HL, McCain MA, McGinigle M. Strengthening Interprofessional Collaboration to Improve Transfers Between a Freestanding Birth Center and an Academic Medical Center. J Midwifery Womens Health 2022; 67:753-758. [PMID: 36433687 DOI: 10.1111/jmwh.13437] [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: 03/28/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/27/2022]
Abstract
The number of individuals choosing to give birth in a freestanding birth center has doubled since 2004. As many as half of all pregnant persons planning for a birth center birth ultimately develop medical complications and are unable to give birth outside of the hospital. Integrating birth centers into their regional perinatal health care system optimizes outcomes by establishing predetermined pathways for antepartum and intrapartum transfers of care and facilitates ongoing communication and cooperation among clinicians. The Vanderbilt Birth Center is a freestanding birth center that is operated by an academic medical center and partners with a hospital-based midwifery practice that cares for patients transferring from the birth center. Since the inception of the birth center in 2015, the entire perinatal team has worked to improve the process and experience of patient transfer from birth center to hospital care. This article will present strategies implemented through the ongoing collaboration between birth center and hospital health care providers. These include adopting a shared electronic health record, clinical practice guidelines that align across birth sites, preparing birth center patients prenatally for the possibility hospital transfer, the presentation of a united team across birth sites, clear and widely disseminated communication pathways for hospital admission and patient handoff, and ongoing opportunities for interteam communication, collaboration, and education. These strategies may benefit similar midwifery practice models as they seek to partner with larger health care systems and improve the transfer experience for their patients.
Collapse
Affiliation(s)
| | - Hannah L Diaz
- Vanderbilt University School of Nursing, Nashville, Tennessee
| | - Manola A McCain
- Vanderbilt University School of Nursing, Nashville, Tennessee
| | | |
Collapse
|
7
|
Barger MK. Systematic Reviews to Inform Practice, July/August 2022. J Midwifery Womens Health 2022; 67:515-520. [PMID: 35851548 DOI: 10.1111/jmwh.13393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Mary K Barger
- Midwifery researcher and consultant, San Diego, California
| |
Collapse
|