Pivoting to Childbirth at Home or in Freestanding Birth Centers1 in the US During COVID-19: Safety, Economics and Logistics

Daviss, Betty-Anne; Anderson, David A.; Johnson, Kenneth C.

doi:10.3389/fsoc.2021.618210

Cited by 16 publications

(15 citation statements)

References 21 publications

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“…65 Accordingly, our findings can inform the development of a patient decision aid to help support women and birthing people consider the risks and benefits, as well as personal values and expectations, associated with various birth settings. 27 Concerns about COVID-19 transmission in hospitals have prompted renewed exploration of birth center and home birth options and analysis of the costs of providing perinatal care in high-risk, high-intervention settings, 20,66,67 increasing the need for a decision aid aimed at supporting birth setting decision making.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing birth setting decision making in the United States: An integrative review

George

Shorten

Lyons

et al. 2022

Birth

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Background The United States has the highest perinatal morbidity and mortality (M&M) rates among all high‐resource countries in the world. Birth settings (birth center, home, or hospital) influence clinical outcomes, experience of care, and health care costs. Increasing use of low‐intervention birth settings can reduce perinatal M&M. This integrative review evaluated factors influencing birth setting decision making among women and birthing people in the United States. Methods A search strategy was implemented within the CINAHL, PubMed, PsycInfo, and Web of Science databases. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guided the review, and the Johns Hopkins Nursing Evidence‐Based Practice model was used to evaluate methodological quality and appraisal of the evidence. The Whittemore and Knafl integrative review framework informed the extraction and analysis of the data and generation of findings. Results We identified 23 articles that met inclusion criteria. Four analytical themes were generated that described factors that influence birth setting decision making in the United States: “Birth Setting Safety vs. Risk,” “Influence of Media, Family, and Friends on Birth Setting Awareness,” “Presence or Absence of Choice and Control,” and “Access to Options.” Discussion Supporting women and birthing people to make informed decisions by providing information about birth setting options and variations in models of care by birth setting is a critical patient‐centered strategy to ensure equitable access to low‐intervention birth settings. Policies that expand affordable health insurance to cover midwifery care in all birth settings are needed to enable people to make informed choices about birth location that align with their values, individual pregnancy characteristics, and preferences.

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Section: Discussionmentioning

confidence: 99%

Factors influencing birth setting decision making in the United States: An integrative review

George

Shorten

Lyons

et al. 2022

Birth

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“… 8 Our findings also support other studies that show how COVID‐19 has affected patients' decisions about place of birth, in that more pregnant patients are considering community birthing models such as home birth because of concerns related to hospital safety and undesirable visitation policies during the pandemic. 22 , 23…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID‐19 on perinatal care: Perceptions of family physicians in the United States

Goldstein

Eden

Taylor

et al. 2022

Birth

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Background Patient‐centered care is the best practice in the care of pregnant and postpartum patients. The COVID‐19 pandemic prompted changes in perinatal care policies, which were often reactive, resulting in unintended consequences, many of which made the delivery of patient‐centered care more difficult. This study aimed to understand the impact of the COVID‐19 pandemic on perinatal health care delivery from the perspective of family physicians in the United States. Methods From October 5 to November 4, 2020, we surveyed mid‐ to late‐career family physicians who provide perinatal care. We conducted descriptive analyses to measure the impact of COVID‐19 on prenatal care, labor and delivery, postpartum care, patient experience, and patient volume. An immersion‐crystallization approach was used to analyze qualitative data provided as open‐text comments. Results Of the 1518 survey respondents, 1062 (69.8%) stated that they currently attend births; 595 of those elaborated about the impact of COVID‐19 on perinatal care in free‐text comments. Eight themes emerged related to the impact of COVID‐19 on perinatal care: visitation, patient decisions, testing, personal protective equipment, care continuity, changes in care delivery, reassignment, and volume. The greatest perceived impact of COVID‐19 was on patient experience. Conclusions Family physicians who provided perinatal care during the COVID‐19 pandemic noted a considerable impact on patient experience, which particularly affected the ability to deliver patient‐centered and family‐centered care. Continued research is needed to understand the long‐term impact of policies affecting the delivery of patient‐centered perinatal care and to inform more evidence‐based, proactive policies to be implemented in future pandemic or disaster situations.

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“…We also believe that US community midwives can seize this pandemic moment to raise national awareness of their value, while obstetricians can become more aware and accepting of the high value and cost-savings of midwifery care and community births. In an analysis comparing the costs of in-vs out-of-hospital births, which also provides ample evidence of the safety of CPM-attended community births, Anderson, Daviss, and Johnson (2021) have shown that, if only 10% more US births took place at home or in freestanding birth centers, the cost-savings would amount to $11 billion , along with improved birth outcomes-or $321 million per percentage raise.…”

Section: Conclusion: Negotiating Integrated and Sustainable Maternity...mentioning

confidence: 99%

Negotiating the Pandemic

Ali¹,

Davis‐Floyd²

2022

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This book centers on negotiations around cultural, governmental, and individual constructions of COVID-19. It considers how the coronavirus pandemic has been negotiated in different cultures and countries, with the fi nal part of the volume focusing on South Asia and Pakistan in particular. The chapters include autoethnographic accounts and ethnographic explorations that refl ect upon experiences of living with the pandemic and its implications for all areas of life. The book explicates people's dealings with COVID-19 at various levels, situates the spread of rumors, conspiracy theories, and new social rituals within micro-and/ or macro-contexts, and describes the interplay between the virus and various institutionalized forms of inequalities and structural vulnerabilities. Bringing together a variety of perspectives, the volume relates to the past, describes the Covidian present, and offers futuristic implications. It enlists distinct imaginaries based on current understandings of an extraordinary challenge that holds signifi cant importance for our human future.An electronic version of this book is freely available, thanks to the support of libraries working with Knowledge Unlatched (KU). KU is a collaborative initiative designed to make high quality books Open Access for the public good. The Open Access ISBN for this book is 9781003187462. More information about the initiative and links to the Open Access version can be found at www.knowledgeunlatched.org .

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Pivoting to Childbirth at Home or in Freestanding Birth Centers1 in the US During COVID-19: Safety, Economics and Logistics

Cited by 16 publications

References 21 publications

Factors influencing birth setting decision making in the United States: An integrative review

Factors influencing birth setting decision making in the United States: An integrative review

Impact of COVID‐19 on perinatal care: Perceptions of family physicians in the United States

Negotiating the Pandemic

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