A systematic review of women's experiences of planning a homebirth in consultation with maternity care providers
Bibliographic record
Abstract
Background A woman’s chosen place of birth impacts not only the type of birth, but also the number of unnecessary interventions that the mother and baby are exposed to during labour and birth. Lower rates of unnecessary interventions are experienced by women who give birth at home. These include oxytocin augmentation, episiotomy, epidural analgesia, instrumental vaginal birth and caesarean section. They are also less likely to experience 3rd or 4th degree perineal tear, maternal infection or postpartum haemorrhage. However, little is known regarding women’s actual experiences of engaging with maternity care providers to plan for a home birth. Aim: To synthesise findings from previous studies, which have reported on women’s experiences of planning a home birth in consultation with maternity care providers. Methods: Nine bibliographic databases were systematically searched using the search terms: Home birth, childbirth, planned home birth, pregnant women and home birth, experience and homebirth. Studies published in English Language between January 2015 and May 2020 were included. Conference abstracts lacking sufficient data were excluded. Relevant papers from back chaining references of papers evidenced within the RQIA Planning birth at home guideline and professional networks were included. We managed search results and deduplication with Endnote, Refworks and Covidence. Screening, quality appraisal and data extraction were done independently by two authors and conflicts were resolved by discussion and agreement. Data analysis is ongoing using thematic synthesis (Thomas and Harden 2008). The review is registered on the International Prospective Register of Systematic Reviews (PROSPERO: Registration ID: CRD 42018095042 – updated 28th September 2020). Findings Search results yielded 586 papers. Following deduplication, title/abstract and full-text screening, 16 eligible studies were included in the review. The studies were qualitative and involved a total of 275 women aged 18 - 40 years old. The studies were conducted across nine countries: Australia, Brazil, USA, UK, Switzerland, Canada, Netherlands, Spain and Norway. Findings showed that preference for a natural birth served as a catalyst for women to be resilient in problem-solving, information-seeking and taking positive actions to actualise a planned home birth in consultation with their midwives. Their midwives’ competence, support and prioritisation of safety and woman-centred care also enhanced women’s confidence and positive experience of planning a home birth. Conclusions/Implications This review gives a more in-depth understanding of women’s information and support needs. In particular, the influence care providers can have on women’s plan to have a home birth has implications for service providers.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.081 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.005 |
| Bibliometrics | 0.021 | 0.028 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".