Process lessons from evaluating a combined continuity of carer and home birth scheme

A dedicated home birth team was established in a deprived inner London borough offering continuity of carer to women choosing home birth. Establishing a new service brought unique challenges, and the team was required to adapt quickly, introducing new ways of managing workload and adapting policies to suit the needs of the population and service. Reflecting on some of the challenges faced in the first year of operation is useful to allow the team to learn and grow, and to help others to establish similar services in their area.

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Experiences of Women Planning a Home Birth Who Require Intrapartum Transfer to Hospital: A Metasynthesis of the Qualitative Literature

International Journal of Childbirth ◽

10.1891/2156-5287.4.2.103 ◽

2014 ◽

Vol 4 (2) ◽

pp. 103-119 ◽

Cited By ~ 10

Author(s):

Deborah Fox ◽

Athena Sheehan ◽

Caroline Homer

Keyword(s):

Qualitative Research ◽

Qualitative Data ◽

Home Birth ◽

Midwifery Care ◽

Making Sense ◽

Planned Home Birth ◽

Experiences Of Women ◽

Continuity Of Carer ◽

Low Risk Women ◽

Qualitative Literature

Recent evidence supports the safety of planned home birth for low-risk women when professional midwifery care and adequate collaborative arrangements for referral and transfer are in place. The purpose of this article is to synthesize the qualitative literature on the experiences of women planning a home birth, who are subsequently transferred from home to hospital. A metasynthesis approach was selected because it aims to create a rich understanding of women’s experiences of transfer by synthesizing and interpreting qualitative data. Three categories were synthesized: “communication, connection, and continuity,” “making the transition,” and “making sense of events.” Quality and clarity of communication, feeling connected to the backup hospital, and continuity of midwifery carer helps make the transfer process as seamless as possible for women. Arriving at the hospital is a time of vulnerability and fear, and retaining the care of a known midwife is reassuring. New caregivers must also be sensitive to women’s need to be reassured and accepted. The reasons for transfer need to be clearly communicated both at the time of transfer and in more detail during the postpartum period. Women need to talk through their experience and to acknowledge their feelings of disappointment in order to move forward in the next phase of their lives. Continuity of carer enables this to be done by a known caregiver in a sensitive and individualized manner. Further qualitative research to examine home birth transfer issues, specifically in the Australian context, is currently being planned as part of the Birthplace in Australia project.

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Creating a dedicated home birth team in Tower Hamlets: a review of outcomes from the first year

British Journal of Midwifery ◽

10.12968/bjom.2019.27.8.507 ◽

2019 ◽

Vol 27 (8) ◽

pp. 507-513 ◽

Cited By ~ 1

Author(s):

Caitlin Foley ◽

Faye Callaghan ◽

Mary Olusile

Keyword(s):

Transfer Rate ◽

Birth Rate ◽

Home Birth ◽

First Year ◽

Minority Populations ◽

Equitable Access ◽

Microsoft Excel ◽

Large Teaching Hospital ◽

Maternal And Neonatal Outcomes ◽

Continuity Of Carer

Background A dedicated home birth team was established at a large teaching hospital in a deprived inner London borough. Aim To increase the home birth rate in Tower Hamlets and offer continuity of carer to women opting for home birth. Methods Data were collected on all 90 women receiving care by the team. Data, including demographics, care episodes and maternal and neonatal outcomes, were recorded and analysed using Microsoft Excel 2010. Findings With a dedicated home birth team, the home birth rate in Tower Hamlets increased by 68% compared to the previous year, while still remaining a small proportion of all births in the borough. The overall transfer rate was 32.6%, in line with national figures. Outcomes for both mothers and babies were very good, with 89% of women who started their labour at home achieving a normal vaginal birth. Feedback was exceptionally positive, with 100% of women who provided feedback recommending the service. The women being referred and choosing homebirth were not demographically representative of the population of the borough. Conclusions The provision of a dedicated homebirth team in Tower Hamlets has been a positive addition to the area's existing maternity services. More needs to be done to improve the visibility of the team in order to secure more referrals and increase the homebirth rate, especially among the Bengali and other ethnic minority populations, to enable equitable access to homebirth.

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Awareness of Pregnant Women for COVID-19 Infection

Tropical Health and Medical Research ◽

10.35916/thmr.v0i0.28 ◽

2020 ◽

Author(s):

Erhan Okuyan ◽

Emre Gunakan ◽

Sertaç Esin

Keyword(s):

Pregnant Women ◽

Respiratory Diseases ◽

Prospective Observational Study ◽

Information Source ◽

Home Birth ◽

Patient Characteristics ◽

Emotional Status ◽

Prevention Method ◽

And Behavior

Covid outbreak has been getting worse and spread affected all over the world. Pregnant patients are also vulnerable to respiratory diseases. We aimed to evaluate the awareness, emotional status, and behavior of pregnant during the COVID outbreak. This study's main benefit is to analyze the knowledge and understanding of pregnant women about the pandemic and draw attention to the prevention issues that need improvement. This research is a prospective observational study that 199 patients subjected to a questionnaire including 29 questions about patient characteristics, pregnancy information, knowledge about COVID19-infection, behavioral and emotional changes. 130 (65.3) of the patients stated an above-average knowledge level. Television was the most frequent information source (75.4%, n:150) and was the only information source for 90 (45.1%) of the patients. Sixty-nine patients used more than one information source. More than one prevention method uses by 149 (75%) of the patients. Washing hands (n:183, 92.0%) and cleaning the house (n:122, 61.3%) were the most preferred methods. Only 55 (27.6%) of the patients used a mask for prevention. 88(44.2%) of the patients stated that they preferred a shorter hospital stay, and 75 (37.7%) of the patients indicated that they postponed or avoided the pregnancy follow-up visits due to the COVID-19 issue. Pregnant women seem to be aware and stressed of COVID-19, but knowledge of what to do seems insufficient. Patients informed of risks of COVID infection, unplanned hospital admission, and chances of avoiding necessary visits and home birth demands.

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