Eight women's experiences of home birth were explored using tape recorded semi-structured interviews. The main themes were identified and presented in the form of dialogue and quotes. This article explores the available literature, describes the methodology and reports the results from the first two themes of the study. The decision to have a home birth was based on previous birth experience, the desire for a familiar environment and concerns over childcare. Expectations centred on maintaining normality, a calm atmosphere and having more control.

Background: Smoking during pregnancy has a detrimental effect on both maternal and neonatal health. The government has agreed a long term goal for New Zealand (NZ) to become a smoke-free nation by 2025, with smoking cessation during pregnancy a government priority. Contemporary information, reviewing the prevalence and demographics of women who smoke during pregnancy, is important so that change can be monitored and cessation support appropriately targeted. Aim: To examine the prevalence of smoking for 81,821 pregnant women who registered with a midwife Lead Maternity Carer (LMC) between the years 2008 to 2010. Methods: A retrospective observational design using aggregated clinical data from the New Zealand College of Midwives clinical outcomes research database (COMCORD) for the years 2008 to 2010. Women's self-reported smoking or smoke-free status was recorded at registration with, and at discharge from, a midwife LMC. Findings: A trend of reduced smoking prevalence at registration was found for this NEW ZEALAND RESEARCH cohort (reduced from 19.5% in 2008 to 18.4% in 2010). Women who identified as Māori had the highest rates of smoking (42.9%) followed by Pasifika (15%) and NZ European ethnicity (13.4%). Women in the 16 to 19 years age group had the highest rate of smoking (39.4%) followed by the under 16 years age group (35.7%). Increasing parity was also associated with an increased likelihood of smoking at registration. By discharge from midwifery care there were reduced rates of smoking across all groups. Conclusion: Overall smoking during pregnancy prevalence rates are trending down with reduced rates of smoking across all groups by discharge from a midwife. Cessation messages and support need to be targeted to young women (under 25years), multiparous women and women of Māori ethnicity.

INTRODUCTION: Early pregnancy registration is recommended and provides an opportunity for screening, risk assessment and health promotion. AIM: To determine the gestation at pregnancy registration for a cohort of pregnant New Zealand women who received maternity care from a midwife Lead Maternity Carer (LMC) and to determine if women are registering earlier in pregnancy. METHODS: The gestation of pregnancy at registration was reviewed for the 81 821 women who registered with a midwife LMC between 2008 and 2010 and had data recorded in the New Zealand College of Midwives Clinical Outcomes Research Database (COMCORD). RESULTS: Over the three-year period, there was a trend towards earlier registration with 22.0% of women registering before 10 weeks' gestation in 2008 increasing to 29.9% in 2010. Women of New Zealand European ethnicity were more likely to register before 10 weeks' gestation compared to women who identified as Maori or Pacific ethnicity. Women under 20 or over 40 years of age were more likely to register in the second or third trimester than other age groups. DISCUSSION: Groups that were slower to register with a midwife LMC were women under 20 years or over 40 years of age and women of Maori or Pacific ethnicity. These groups have higher perinatal mortality rates, higher rates of smoking and lower uptake of antenatal Down syndrome screening. Further research is required to explore the barriers to earlier registration for these groups. KEYWORDS: Midwifery; pregnancy; pregnancy trimester, first; prenatal care

This second article explores the home birth experience and the time after the birth. The women perceived their home births as being positive, this increased their confidence and led to feelings of mastery over the labour and birth. They valued the support of the midwives although their overall manner was more important than knowing them. It was recognised that partners felt able to take a more active role, while other children found it easier to adapt to their new sibling. The time after the birth was seen as a more celebratory and family event. Overall birth at home was seen as a fulfilling and empowering experience.

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