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A systematic review to examine the evidence regarding discussions by midwives, with women, around their options for where to give birth
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Henshall, Catherine, Taylor, Beck and Kenyon, Sara (2016) A systematic review to examine the evidence regarding discussions by midwives, with women, around their options for where to give birth. BMC Pregnancy and Childbirth, 16 (1). 53. doi:10.1186/s12884-016-0832-0 ISSN 1471-2393.
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Official URL: http://doi.org/10.1186/s12884-016-0832-0
Abstract
Background
Discussion of place of birth is important for women and maternity services, yet the detail, content and delivery of these discussions are unclear. The Birthplace Study found that for low risk, multiparous women, there was no significant difference in neonatal safety outcomes between women giving birth in obstetric units, midwifery-led units, or home. For low risk, nulliparous women giving birth in a midwifery-led unit was as safe as in hospital, whilst birth at home was associated with a small, increased risk of adverse perinatal outcomes. Intervention rates were reduced in all settings outside hospital. NICE guidelines recommend all women are supported in their choice of birth setting.
Midwives have the opportunity to provide information to women about where they choose to give birth. However, research suggests women are sometimes unaware of all the options available.
This systematic review will establish what is known about midwives’ perspectives of discussions with women about their options for where to give birth and whether any interventions have been implemented to support these discussions.
Methods
The systematic review was PROSPERO registered (registration number: CRD42015017334). The PRISMA statement was followed. Medline, Cochrane, CINAHL, PsycINFO, Popline and EMBASE databases were searched between 2000-March 2015 and grey literature was searched. All identified studies were screened for inclusion. Qualitative data was thematically analysed, whilst quantitative data was summarised.
Results
The themes identified relating to influences on midwives’ place of birth discussions with women were organisational pressures and professional norms, inadequate knowledge and confidence of midwives, variation in what midwives told women and the influence of colleagues. None of the interventions identified provided sufficient evidence of effectiveness and were of poor quality.
Conclusions
The review has suggested the need for a pragmatic, understandable place of birth dialogue containing standard content to ensure midwives provide low risk women with adequate information about their place of birth options and the need to improve midwives knowledge about place of birth. A more robust, systematic evaluation of any interventions designed is required to improve the quality of place of birth discussions. By engaging with co-produced research, more effective interventions can be designed, implemented and sustained.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RG Gynecology and obstetrics | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
Library of Congress Subject Headings (LCSH): | Childbirth, Birthplaces -- Great Britain, Midwives -- Great Britain, Midwifery, Hospitals -- Maternity services, Labor (Obstetrics), Childbirth at home, Maternal health services -- Great Britain | ||||||
Journal or Publication Title: | BMC Pregnancy and Childbirth | ||||||
Publisher: | BioMed Central Ltd. | ||||||
ISSN: | 1471-2393 | ||||||
Official Date: | 14 March 2016 | ||||||
Dates: |
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Volume: | 16 | ||||||
Number: | 1 | ||||||
Article Number: | 53 | ||||||
DOI: | 10.1186/s12884-016-0832-0 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 24 May 2023 | ||||||
Date of first compliant Open Access: | 25 May 2023 | ||||||
RIOXX Funder/Project Grant: |
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