Planned Home Birth in Low-Risk Pregnancies in Spain: A Descriptive Study

Previous studies have shown that planned home birth in low-risk pregnancies is a generally safe option. However nowadays, only 0.5 percent of deliveries have been at home in Spain. This study sought to understand the characteristics of planned home births with qualified healthcare professionals in low-risk pregnancies and their results on maternal and neonatal health in the Balearic Islands. The study followed a retrospective descriptive design to investigate planned home births from 1989 to 2019 (n = 820). Sociodemographic data of women, healthcare professional intervention rates, and maternal/fetal morbidity/mortality results were collected. Statistical analysis of the results was performed using the IBM SPSS Version 25 software package. The results indicated that women with low-risk pregnancies who planned home births with a qualified midwife had a higher probability of spontaneous vaginal birth delivery and positive maternal health results. Furthermore, the risk of hospital transfer was low (10.7%) and the rate of prolonged breastfeeding (>1 year) was extremely high (99%). Moreover, the study showed that planned home births can be generally associated with fetal well-being. The conclusions and implications of this study are that planned home births in low-risk pregnancies attended by qualified midwives in the Balearic Islands achieve positive results in both maternal and newborn health, as well as low rates of obstetric intervention.

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The Canadian birth place study: examining maternity care provider attitudes and interprofessional conflict around planned home birth

10.32920/14636766.v1 ◽

2021 ◽

Author(s):

Saraswathi Vedam ◽

Kathrin Stoll ◽

Laura Schummers ◽

Nichole Fairbrother ◽

Michael C Klein ◽

...

Keyword(s):

Care Provider ◽

Home Birth ◽

Outcome Variable ◽

Categorical Variables ◽

Provider Type ◽

Provider Attitudes ◽

Home Births ◽

Birth Place ◽

Obstetric Emergencies ◽

Planned Home Birth

Background Available birth settings have diversified in Canada since the integration of regulated midwifery. Midwives are required to offer eligible women choice of birth place; and 25-30% of midwifery clients plan home births. Canadian provincial health ministries have instituted reimbursement schema and regulatory guidelines to ensure access to midwives in all settings. Evidence from well-designed Canadian cohort studies demonstrate the safety and efficacy of midwife-attended home birth. However, national rates of planned home birth remain low, and many maternity providers do not support choice of birth place. Methods In this national, mixed-methods study, our team administered a cross-sectional survey, and developed a 17 item Provider Attitudes to Planned Home Birth Scale (PAPHB-m) to assess attitudes towards home birth among maternity providers. We entered care provider type into a linear regression model, with the PAPHB-m score as the outcome variable. Using Students’ t tests and ANOVA for categorical variables and correlational analysis (Pearson’s r) for continuous variables, we conducted provider-specific bivariate analyses of all socio-demographic, education, and practice variables (n=90) that were in both the midwife and physician surveys. Results Median favourability scores on the PAPHB–m scale were very low among obstetricians (33.0), moderately low for family physicians (38.0) and very high for midwives (80.0), and 84% of the variance in attitudes could be accounted for by care provider type. Amount of exposure to planned home birth during midwifery or medical education and practice was significantly associated with favourability scores. Concerns about perinatal loss and lawsuits, discomfort with inter-professional consultations, and preference for the familiarity of the hospital correlated with less favourable attitudes to home birth. Among all providers, favourability scores were linked to beliefs about the evidence on safety of home birth, and confidence in their own ability to manage obstetric emergencies at a home birth. Conclusions Increasing the knowledge base among all maternity providers about planned home birth may increase favourability. Key learning competencies include criteria for birth site selection, management of obstetric emergencies at planned home births, critical appraisal of literature on safety of home birth, and inter-professional communication and collaboration when women are transferred from home to hospital.

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Experience of women in the transfer from planned home birth to hospital

Rev Rene ◽

10.15253/2175-6783.20202143948 ◽

2020 ◽

Vol 21 ◽

pp. e43948

Author(s):

Marina Fabricio Ribeiro Pereira ◽

Suéllen de Sousa Rodrigues ◽

Mariana de Sousa Dantas Rodrigues ◽

Wilma Ferreira Guedes Rodrigues ◽

Morganna Guedes Batista ◽

...

Keyword(s):

Oral History ◽

Home Environment ◽

Home Birth ◽

Structured Interview ◽

Motivating Factors ◽

Obstetric Violence ◽

Hospital Transfer ◽

Positive Experiences ◽

Planned Home Birth ◽

Experiences Of Women

Objective: to describe the experiences of women in the transfer from planned home birth to the hospital. Methods: qualitative research, subsidized by Thematic Oral History, in which six women participated, attended by the home birth team and transferred to a maternity ward, during the parturition process. The semi-structured interview script with oral history generated five categories. Results: five thematic categories emerged: Motivating factors for choosing planned home birth; Positive experiences on intrapartum care in the home environment; Indications of hospital transfer; Feelings experienced during and after hospital transfer; Obstetric violence during hospitalization. Conclusion: the motivations for choosing planned home birth favored the positive experience of the parturition process, while hospitalization reflected obstetric violence.

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Quality of Maternal and Newborn Health Care in Ethiopia: A Cross-Sectional Study

10.21203/rs.3.rs-141660/v1 ◽

2021 ◽

Author(s):

Abera Biadgo ◽

Aynalem Legesse ◽

Abiy Seifu ◽

Kavita Singh ◽

Zewdie Mulissa ◽

...

Keyword(s):

Health Care ◽

Quality Of Care ◽

Newborn Health ◽

Health Facilities ◽

Maternal And Newborn Health ◽

Neonatal Health ◽

Input Process ◽

Maternal And Neonatal Health ◽

Maternal And Newborn

Abstract Background: Despite reports of universal access to and modest utilization of maternal and newborn health services in Ethiopia, mothers and newborns continue to die from preventable causes. Studies indicate this could be due to poor quality of care provided in health systems. Evidences show that high quality health care prevents more than half of all maternal deaths. In Ethiopia, there is limited knowledge surrounding the status of the quality of maternal and newborn health care in health facilities. This study aims to assess the quality of maternal and neonatal health care provision at the health facility level in four regions in Ethiopia.Methodology: This study employed a facility-based cross-sectional study design. It included 32 health facilities which were part of the facilities for prototyping maternal and neonatal health quality improvement interventions. Data was collected using a structured questionnaire, key informant interviews and record reviews. Data was entered in Microsoft Excel and exported to STATA for analysis. Descriptive analysis results are presented in texts, tables and graphs. Quality of maternal and neonatal health care was measured by input, process and outputs components. The components were developed by computing scores using standards used to measure the three components of the quality of maternal and neonatal health care.Result: The study was done in a total of 32 health facilities: 5 hospitals and 27 health centers in four regions. The study revealed that the average value of the quality of the maternal and neonatal health care input component among health facilities was 62%, while the quality of the process component was 43%. The quality of the maternal and neonatal health output component was 48%. According to the standard cut-off point for MNH quality of care, only 5 (15.6%), 3 (9.3%) and 3 (10.7%) of health facilities met the expected input, process and output maternal and neonatal health care quality standards, respectively.Conclusion: This study revealed that the majority of health facilities did not meet the national MNH quality of care standards. Focus should be directed towards improving the input, process and output standards of the maternal and neonatal health care quality, with the strongest focus on process improvement.

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Planned home birth with a regulated midwife is as safe as hospital birth for low-risk women

Evidence-based Healthcare ◽

10.1054/ebhc.2002.0519 ◽

2002 ◽

Vol 6 (3) ◽

pp. 119

Author(s):

Patricia Aikins Murphy

Keyword(s):

Home Birth ◽

Low Risk ◽

Hospital Birth ◽

Planned Home Birth ◽

Low Risk Women

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Differences in optimality index between planned place of birth in a birth centre and alternative planned places of birth, a nationwide prospective cohort study in The Netherlands: results of the Dutch Birth Centre Study

BMJ Open ◽

10.1136/bmjopen-2017-016958 ◽

2017 ◽

Vol 7 (11) ◽

pp. e016958 ◽

Cited By ~ 5

Author(s):

Marieke A A Hermus ◽

Marit Hitzert ◽

Inge C Boesveld ◽

M Elske van den Akker-van Marle ◽

Paula van Dommelen ◽

...

Keyword(s):

Cohort Study ◽

Pregnant Women ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Home Birth ◽

Low Risk ◽

Place Of Birth ◽

Home Births ◽

Birth Centre ◽

Hospital Births

ObjectivesTo compare the Optimality Index of planned birth in a birth centre with planned birth in a hospital and planned home birth for low-risk term pregnant women who start labour under the responsibility of a community midwife.DesignProspective cohort study.SettingLow-risk pregnant women under care of a community midwife and living in a region with one of the 21 participating Dutch birth centres or in a region with the possibility for midwife-led hospital birth. Home birth was commonly available in all regions included in the study.Participants3455 low-risk term pregnant women (1686 nulliparous and 1769 multiparous) who gave birth between 1 July 2013 and 31 December 2013: 1668 planned birth centre births, 701 planned midwife-led hospital births and 1086 planned home births.Main outcome measurementsThe Optimality IndexNL-2015, a tool to measure ‘maximum outcome with minimal intervention’, was assessed by planned place of birth being a birth centre, a hospital setting or at home. Also, a composite maternal and perinatal adverse outcome score was calculated for the different planned places of birth.ResultsThere were no differences in Optimality Index NL-2015 for pregnant women who planned to give birth in a birth centre compared with women who planned to give birth in a hospital. Although effect sizes were small, women who planned to give birth at home had a higher Optimality Index NL-2015 than women who planned to give birth in a birth centre. The differences were larger for multiparous than for nulliparous women.ConclusionThe Optimality Index NL-2015 for women with planned birth centre births was comparable with planned midwife-led hospital births. Women with planned home births had a higher Optimality Index NL-2015, that is, a higher sum score of evidence-based items with an optimal value than women with planned birth centre births.

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Planned Home Birth Can Be as Safe as Hospital Delivery for Women with Low-Risk Pregnancies

Family Planning Perspectives ◽

10.2307/2953338 ◽

1997 ◽

Vol 29 (3) ◽

pp. 141 ◽

Cited By ~ 1

Author(s):

L. Remez

Keyword(s):

Home Birth ◽

Low Risk ◽

Hospital Delivery ◽

Planned Home Birth

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Quality of maternal and newborn health care in Ethiopia: a cross-sectional study

BMC Health Services Research ◽

10.1186/s12913-021-06680-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Abera Biadgo ◽

Aynalem Legesse ◽

Abiy Seifu Estifanos ◽

Kavita Singh ◽

Zewdie Mulissa ◽

...

Keyword(s):

Health Care ◽

Quality Of Care ◽

Newborn Health ◽

Health Facilities ◽

Maternal And Newborn Health ◽

Neonatal Health ◽

Input Process ◽

Maternal And Neonatal Health ◽

Maternal And Newborn

Abstract Background Despite reports of universal access to and modest utilization of maternal and newborn health services in Ethiopia, mothers and newborns continue to die from preventable causes. Studies indicate this could be due to poor quality of care provided in health systems. Evidences show that high quality health care prevents more than half of all maternal deaths. In Ethiopia, there is limited knowledge surrounding the status of the quality of maternal and newborn health care in health facilities. This study aims to assess the quality of maternal and neonatal health care provision at the health facility level in four regions in Ethiopia. Methodology This study employed a facility-based cross-sectional study design. It included 32 health facilities which were part of the facilities for prototyping maternal and neonatal health quality improvement interventions. Data was collected using a structured questionnaire, key informant interviews and record reviews. Data was entered in Microsoft Excel and exported to STATA for analysis. Descriptive analysis results are presented in texts, tables and graphs. Quality of maternal and neonatal health care was measured by input, process and outputs components. The components were developed by computing scores using standards used to measure the three components of the quality of maternal and neonatal health care. Result The study was done in a total of 32 health facilities: 5 hospitals and 27 health centers in four regions. The study revealed that the average value of the quality of the maternal and neonatal health care input component among health facilities was 62%, while the quality of the process component was 43%. The quality of the maternal and neonatal health output component was 48%. According to the standard cut-off point for MNH quality of care, only 5 (15.6%), 3 (9.3%) and 3 (10.7%) of health facilities met the expected input, process and output maternal and neonatal health care quality standards, respectively. Conclusion This study revealed that the majority of health facilities did not meet the national MNH quality of care standards. Focus should be directed towards improving the input, process and output standards of the maternal and neonatal health care quality, with the strongest focus on process improvement.

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Association of Maternal Observation and Motivation (MOM) Program with m-Health Support on Maternal and Newborn Health

Healthcare ◽

10.3390/healthcare9121629 ◽

2021 ◽

Vol 9 (12) ◽

pp. 1629

Author(s):

Premalatha Paulsamy ◽

Vigneshwaran Easwaran ◽

Rizwan Ashraf ◽

Shadia Hamoud Alshahrani ◽

Krishnaraju Venkatesan ◽

...

Keyword(s):

Physical Activity ◽

Birth Weight ◽

Newborn Health ◽

Well Being ◽

Maternal And Newborn Health ◽

Control Group ◽

Study Group ◽

Health Support ◽

Pregnant Mothers ◽

Maternal And Newborn

Maternal and child nutrition has been a critical component of health, sustainable development, and progress in low- and middle-income countries (LMIC). While a decrement in maternal mortality is an important indicator, simply surviving pregnancy and childbirth does not imply better maternal health. One of the fundamental obligations of nations under international human rights law is to enable women to endure pregnancy and delivery as an aspect of their enjoyment of reproductive and sexual health and rights and to live a dignified life. The aim of this study was to discover the correlation between the Maternal Observation and Motivation (MOM) program and m-Health support for maternal and newborn health. A comparative study was done among 196 pregnant mothers (study group—94; control group—102 mothers) with not less than 20 weeks of gestation. Maternal outcomes such as Hb and weight gain and newborn results such as birth weight and crown–heel length were obtained at baseline and at 28 and 36 weeks of gestation. Other secondary data collected were abortion, stillbirth, low birth weight, major congenital malformations, twin or triplet pregnancies, physical activity, and maternal well-being. The MOM intervention included initial face-to-face education, three in-person visits, and eight virtual health coaching sessions via WhatsApp. The baseline data on Hb of the mothers show that 31 (32.98%) vs. 27 (28.72%) mothers in the study and control group, respectively, had anemia, which improved to 27.66% and 14.98% among study group mothers at 28 and 36 weeks of gestation (p < 0.001). The weight gain (p < 0.001), level of physical activity (p < 0.001), and maternal well-being (p < 0.01) also had significant differences after the intervention. Even after controlling for potentially confounding variables, the maternal food practices regression model revealed that birth weight was directly correlated with the consumption of milk (p < 0.001), fruits (p < 0.01), and green vegetables (p < 0.05). As per the physical activity and maternal well-being regression model, the birth weight and crown–heel length were strongly related with the physical activity and maternal well-being of mothers at 36 weeks of gestation (p < 0.05). Combining the MOM intervention with standard antenatal care is a safe and effective way to improve maternal welfare while upholding pregnant mothers’ human rights.

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