Getting kicked off the program: Women's experiences of antenatal exclusion from publicly-funded homebirth in Australia.

Coddington, R; Fox, D; Scarf, V; Catling, C

Getting kicked off the program: Women's experiences of antenatal exclusion from publicly-funded homebirth in Australia.

Coddington, R

Fox, D

Scarf, V

Catling, C

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Publisher:: Elsevier BV
Publication Type:: Journal Article
Citation:: Women Birth, 2022, pp. S1871-5192(22)00109-3
Issue Date:: 2022-06-25

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Field	Value	Language
dc.contributor.author	Coddington, R https://orcid.org/0000-0003-2438-382X
dc.contributor.author	Fox, D https://orcid.org/0000-0002-8032-8633
dc.contributor.author	Scarf, V https://orcid.org/0000-0003-3503-9610
dc.contributor.author	Catling, C https://orcid.org/0000-0001-7352-2879
dc.date.accessioned	2022-11-30T04:34:30Z
dc.date.available	2022-06-20
dc.date.available	2022-11-30T04:34:30Z
dc.date.issued	2022-06-25
dc.identifier.citation	Women Birth, 2022, pp. S1871-5192(22)00109-3
dc.identifier.issn	1871-5192
dc.identifier.issn	1878-1799
dc.identifier.uri	http://hdl.handle.net/10453/163926
dc.description.abstract	PROBLEM: Eligibility criteria for publicly-funded homebirth models are strict and, as such, many women who initially plan a homebirth later become excluded. BACKGROUND: Fifteen publicly-funded homebirth programs are operating in Australia, offering eligible women the opportunity to give birth at home at no cost, with the care of a hospital-employed midwife. AIM: To explore the experiences of women who planned a publicly-funded homebirth and were later excluded due to pregnancy complications or risk factors. METHODS: A qualitative descriptive approach was taken. Recruitment was via social media sites specifically related to homebirth in Australia. Data collection involved semi-structured telephone interviews. Transcripts were thematically analysed. FINDINGS: Thirteen women participated. They were anxious about 'Jumping through hoops' to maintain their low-risk status. After being 'Kicked off the program', women carefully 'negotiated the system' in order to get the birth they wanted in hospital. Some women felt bullied and coerced into complying with hospital protocols that did not account for their individual needs. Maintaining the midwife-woman relationship was a protective factor, decreasing negative experiences. DISCUSSION: Women plan a homebirth to avoid the medicalised hospital environment and to gain access to continuity of midwifery care. To provide maternity care that is acceptable to women, hospital institutions need to design services that enable continuity of the midwife-woman relationship and assess risk on an individual basis. CONCLUSION: Exclusion from publicly-funded homebirth has the potential to negatively impact women who may feel a sense of loss, uncertainty or emotional distress related to their planned place of birth.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier BV
dc.relation	Philips Medizin Systeme Böblingen GmbH
dc.relation	Biorithm Pte Ltd
dc.relation.ispartof	Women Birth
dc.relation.isbasedon	10.1016/j.wombi.2022.06.008
dc.rights	info:eu-repo/semantics/embargoedAccess
dc.subject	11 Medical and Health Sciences
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.title	Getting kicked off the program: Women's experiences of antenatal exclusion from publicly-funded homebirth in Australia.
dc.type	Journal Article
utslib.location.activity	Netherlands
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Midwifery
utslib.copyright.status	open_access	*
utslib.copyright.embargo	2024-06-01T00:00:00+1000Z
dc.date.updated	2022-11-30T04:34:29Z
pubs.publication-status	Published online

Abstract:

PROBLEM: Eligibility criteria for publicly-funded homebirth models are strict and, as such, many women who initially plan a homebirth later become excluded. BACKGROUND: Fifteen publicly-funded homebirth programs are operating in Australia, offering eligible women the opportunity to give birth at home at no cost, with the care of a hospital-employed midwife. AIM: To explore the experiences of women who planned a publicly-funded homebirth and were later excluded due to pregnancy complications or risk factors. METHODS: A qualitative descriptive approach was taken. Recruitment was via social media sites specifically related to homebirth in Australia. Data collection involved semi-structured telephone interviews. Transcripts were thematically analysed. FINDINGS: Thirteen women participated. They were anxious about 'Jumping through hoops' to maintain their low-risk status. After being 'Kicked off the program', women carefully 'negotiated the system' in order to get the birth they wanted in hospital. Some women felt bullied and coerced into complying with hospital protocols that did not account for their individual needs. Maintaining the midwife-woman relationship was a protective factor, decreasing negative experiences. DISCUSSION: Women plan a homebirth to avoid the medicalised hospital environment and to gain access to continuity of midwifery care. To provide maternity care that is acceptable to women, hospital institutions need to design services that enable continuity of the midwife-woman relationship and assess risk on an individual basis. CONCLUSION: Exclusion from publicly-funded homebirth has the potential to negatively impact women who may feel a sense of loss, uncertainty or emotional distress related to their planned place of birth.

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http://hdl.handle.net/10453/163926