The influences on women who choose a publicly-funded homebirth in Australia
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In Australia, homebirth has not been a mainstream option for childbirth for many years due to political reasons, societal attitudes towards childbirth, and a lack of services Since the 1990s, publicly-funded homebirth services have developed as a result of a growing demand from women and midwives. These services are few in number, and often embedded within a midwifery group practice in a hospital setting. As a relatively new model of care, these services have had little formal research, and only a few evaluations. The purpose of this study was to explore the influences on women who chose a publicly-funded homebirth. The setting was a publicly-funded homebirth service in southern Sydney, New South Wales, Australia. A grounded theory methodology, using a feminist approach was used to collect and analyse the data. Data were collected though semi-structured interviews of 18 women, 5 midwives and 2 partners of the women. Six main categories emerged from the data. These described the influences women had when they chose to have a publicly-funded homebirth. These categories were feeling independent, strong and confident, doing it my way, protection from hospital related activities, having a safety net, selective listening and telling, and engaging support. The core category was having faith in normal. This category linked all the other categories and was an overriding attitude towards themselves as women and the process of childbirth. The basic social process was validating the decision to have a homebirth. This was a dynamic, changeable process and principally a strategy to lessen stress regarding their decision to have a homebirth by reinforcing already-held reasons (for example, their ‘low risk’ status, strength and ability to have a normal birth) and beliefs (for example, their faith in normal, natural processes). The findings establish that women have similar influences to other studies of women when choosing homebirth. However, the women in this study were reassured by the publicly-funded system’s ‘safety net’ and seamless links with the hospital system. The flexibility of the service to permit women to change their minds to give birth in hospital, and essentially choose their birthplace at any time during pregnancy or labour was also appreciated.
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