Experiences of women who have planned unassisted home births: a systematic review protocol

Macdonald, Danielle; Etowa, Josephine; Helwig, Melissa

doi:10.11124/jbisrir-2017-003654

Cited by 6 publications

(9 citation statements)

References 13 publications

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“…Previous syntheses of this research suggest that women make this choice, for reasons of autonomy, choice, and control over their own bodies, due to midwives and current maternity services [ 32 , 87 ]. This body of literature is currently being further synthesized in order to supplement previous research in this area [ 88 , 89 ].…”

Section: Discussionmentioning

confidence: 99%

Global stakeholder perspectives of home birth: a systematic scoping review

et al. 2021

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Home birth is experienced by people very differently worldwide. These experiences likely differ by the type of stakeholder involved (women, their support persons, birth attendants, policy-makers), the experience itself (low-risk birth, transfer to hospital, previous deliveries), and by the health system within which home birth occurs (e.g., high-resource versus low- and middle-resource countries). Research evidence of stakeholders’ perspectives of home birth could usefully inform personal and policy decisions about choosing and providing home birth, but the current literature is fragmented and its breadth is not fully understood.We conducted a systematic scoping review to understand how the research literature on stakeholders’ perspectives of home birth is characterized in terms of populations, settings and identified issues, and what potential gaps exist in the research evidence. A range of electronic, web-based and key informant sources of evidence were searched. Located references were assessed, data extracted, and descriptively analyzed using robust methods.Our analysis included 460 full reports. Findings from 210 reports of studies in high-resource countries suggested that research with fathers and same-sex partners, midwives, and vulnerable populations and perspectives of freebirth and transfer to hospital could be synthesized. Gaps in primary research exist with respect to family members, policy makers, and those living in rural and remote locations. A further 250 reports of studies in low- and middle-resource countries suggested evidence for syntheses related to fathers and other family members, policy makers, and other health care providers and examination of issues related to emergency transfer to hospital, rural and remote home birth, and those who birth out of hospital, often at home, despite receiving antenatal care intended to increase healthcare-seeking behavior. Gaps in primary research suggest an examination is needed of perspectives in countries with higher maternal mortality and among first-time mothers and young mothers.Our scoping review identified a considerable body of research evidence on stakeholder perspectives of home birth. These could inform the complex factors influencing personal decisions and health system planning around home birth in both high- and low- and middle-resource countries. Future primary research is warranted on specific stakeholders worldwide and with vulnerable populations in areas of high maternal mortality.

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Section: Discussionmentioning

confidence: 99%

Global stakeholder perspectives of home birth: a systematic scoping review

et al. 2021

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“…Frequently, birth parents choose to birth in a maternity suite or in hospital under the expert care of midwives or obstetricians 27. However, for this review, we specifically consider OOHBs where emergency ambulance clinicians are called for assistance.…”

Section: Methods and Analysismentioning

confidence: 99%

Out-of-hospital births and the experiences of emergency ambulance clinicians and birthing parents: a scoping review protocol

et al. 2022

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IntroductionEmergency ambulance clinicians attend a wide range of prehospital emergencies, including out-of-hospital births (OOHBs). Intrapartum care comprises approximately 0.05% of emergency medical services’ caseload, with only ~10% of intrapartum cases progressing to birth in emergency ambulance clinician care. However, this low exposure rate potentially allows obstetric clinical skills and knowledge to decay, which may impact on patient care. Additionally, unplanned OOHBs are known to have a higher incidence of complications and adverse outcomes than their counterparts born in hospital, such as postpartum haemorrhage or hypothermia. This scoping review will explore OOHBs and associated complications in emergency ambulance clinician care, investigate birth parent, significant partner and clinician experiences regarding OOHBs, and consider barriers and challenges to optimal patient care, to identify future research opportunities and associated knowledge gaps for this patient cohort.Methods and analysisThis scoping review will follow the nine-step methodological framework suggested by the Joanna Briggs Institute and use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Five electronic databases (MEDLINE via EBSCO, CINAHL, Embase, Web of Science and Wiley Online) will be searched to identify articles for inclusion. The ‘participant, concept, context’ criteria will be used to identify suitable search words regarding OOHBs in emergency ambulance clinician care. The review will include peer-reviewed and preprint literature. Two reviewers will independently assess articles based on title and abstract for inclusion in the review. Data will be charted using a data extraction tool for consistency and provide a succinct descriptive summary of the results.Ethics and disseminationThis study does not require ethical review as all the information obtained will come from publicly available resources. Results will be disseminated via a peer-reviewed publication. This scoping review is preregistered with the Open Science Framework (https://osf.io/ta35q).

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“…The main reason for exclusion at this stage was that the study did not meet the 6/10 threshold for inclusion as outlined in the protocol (see Appendix III). 24 A final total of 6 records 13,[30][31][32][33][34] were included in the systematic review.…”

Section: Study Inclusionmentioning

confidence: 99%

“…Studies published in English were included as per the protocol. 24 Our search strategies were not limited to English-only studies, and one non-English study was identified during the screening process. Studies published from database inception to March 2022 were included in this review to ensure that all experiences of planned unassisted birth were captured.…”

Section: Search Strategymentioning

confidence: 99%

Experiences of women who have planned unassisted home births in high-resource countries: a qualitative systematic review

Macdonald

Helwig

Snelgrove‐Clarke

2023

JBI Evidence Synthesis

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The aim of this review was to identify, appraise, and synthesize the qualitative evidence about the experiences of women in high-resource countries who have planned unassisted home births.Introduction: Unassisted birth occurs when a woman chooses to give birth without the assistance of health care providers. These births are planned and usually occur in a woman's home. It is difficult to know the prevalence of unassisted birth because it occurs at the margins of health care systems, making data difficult to collect. Based on its lack of visibility in society, we assume that unassisted birth is not a common birth choice. Women who choose planned unassisted birth may face stigma for their decision and their experience of birth, which challenge accepted norms. Synthesizing qualitative evidence about women's experiences of planned unassisted birth can improve our understanding about women's birthing values and provide important clues about aspects of birthing care that may be missing in mainstream birthing services.Inclusion criteria: Studies that explored the experiences of women who had planned unassisted home births without the support of health care providers in high-resource countries were included. Unassisted home births were defined as those that were planned not to be assisted by health care professionals. Study designs that focused on qualitative data were eligible for inclusion.Methods: MEDLINE (Ovid), Embase, CINAHL (EBSCO), Scopus, Web of Science, Sociological Abstracts (Pro-Quest), ProQuest Dissertations and Theses (ProQuest), and Nursing and Allied Health Database (ProQuest) were searched in 2022. Studies published in English since the databases' inception were considered for inclusion. A search of relevant websites for unpublished and gray literature was also undertaken in 2022. Two independent reviewers assessed the methodological quality of papers identified for inclusion. Qualitative research findings were extracted from papers that met the inclusion criteria and critical appraisal standard. Findings were extracted and categorized based on similarity of meaning. The categories were synthesized to create 2 synthesized findings, and the ConQul approach was used to grade the findings to establish confidence in the synthesized findings.Results: Six studies were included in the review. All the studies used interviews for data collection; other methods included surveys, email correspondence, posts on internet discussion boards and forums, and websites. The total sample size for interviews was 103 participants. Total survey sample size for surveys was 87 participants. Total sample size for email correspondence was 5. Internet data sources included more than 100,000 individual and forum posts and 127 birth stories. A total of 17 findings were extracted and grouped into 4 categories. The 4 categories were then synthesized into 2 synthesized findings: i) navigating tensions within self, and between self and systems, and ii) integrating and transcending physical experiences of birth.Conclusions: More research ...

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Experiences of women who have planned unassisted home births: a systematic review protocol

Cited by 6 publications

References 13 publications

Global stakeholder perspectives of home birth: a systematic scoping review

Global stakeholder perspectives of home birth: a systematic scoping review

Out-of-hospital births and the experiences of emergency ambulance clinicians and birthing parents: a scoping review protocol

Experiences of women who have planned unassisted home births in high-resource countries: a qualitative systematic review

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