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How do women who have given birth both in hospital and at home perceive their birth experience?
In February 2023 survey Published in the journal Women and Birth, three Irish researchers attempted to answer this question.
In this study, ”It couldn’t have been more different.’ Comparing hospital and home birth experiences in Ireland: a mixed-method study,’ surveyed 141 women about their 10-year experience. .
Home birth versus hospital birth
Published by Elsevier on behalf of the Australian Midwives, the study looked at a group of women who had the unique experience of giving birth both at home and in a hospital.
All study participants were 18 years of age or older and had at least one home birth and one hospital birth in the last 10 years.
Ireland has a particularly high number of hospital births compared to other developed countries in Europe, according to researchers. I didn’t.
The scientists explained that two research questions guided their investigation:
1. How do women who received maternity care rate the antenatal and labor care they received in their setting?
2. How do women feel and describe their experience of giving birth at home or in a hospital?
Investigation of mixed methods of home birth and hospital birth
Irish researchers collected the data using what is called a “mixed method study”. That means he found participants through his closed Facebook group, which has nearly 2,000 members, and posts on Twitter. On each platform, we placed a link to a survey that participants could complete.
We then anonymized the data we collected and removed any personally identifiable information.
In addition to asking women 31 multiple-choice questions, the survey included three open-ended questions.
Data were then processed for statistical significance.
The authors sought to both “quantify the subjective comparative satisfaction of home and hospital births for individuals, while at the same time providing qualitative data to investigate participants’ experiences.”
Their work essentially takes these women’s subjective experiences and packages them into a measurable score that can be meaningfully compared to the mother’s experience of giving birth in a hospital versus at home. It was to do so.
Their “scoring system” allowed them to score a total of 10 points on any question. The closer to 10, the more positive the experience.
Is it natural, safe and normal, or is an accident waiting?
The researchers highlighted two different birth models experienced by Irish women.
What they called the “social model of birth” assumes that birth is natural, safetyand a normal physiological process that does not require medical intervention for most people.
The so-called “medical model” of birth, on the other hand, postulates birth as a potentially risky pathological process (essentially like a disease). In the medical model, childbirth is inherently dangerous and must be managed.
In the medical model of childbirth, to be safe, a woman and baby giving birth must be in a hospital setting with access to a full suite of medical equipment, under the supervision of a highly trained obstetrician.
According to mothers, the more natural the birth, the better the experience
The majority of American mothers give birth under the medical model. national demographic systemwhich provides the most complete data on births and deaths in the United States.
In fact, over 98% of U.S. babies are born in hospitals.
Out-of-hospital births, which include home births and births in independent birth centers, usually attended by midwives, account for less than 2% of all births in the United States.
However, Irish researchers found that study participants’ feelings about birth were strongly consistent with the social approach. Women had a much more positive and empowering experience giving birth at home than giving birth in a hospital.
“The further away the care is from the social model, the less positive perceptions participants have,” the researchers explain.
When they tabulated their data, the Irish researchers identified several things that influence whether the experience of childbirth is remembered as positive or negative.
relationships matter
Women ranked the experience of giving birth at home as 9.9 out of 10, but in a hospital only 5 out of 10.
Home births tended to occur in settings where the mother was cared for by a midwife with whom she had an ongoing relationship. In contrast, the hospital experience did not prioritize relationships and resulted in impersonal care.
Unwanted procedures do not make childbirth positive
Informed consent refers to the process of communication between a doctor or other healthcare provider and a patient.
The idea is that all patients have a right to information that will help them make informed decisions. They should describe the benefits, risks, and alternatives (including the do-nothing alternative) to any particular procedure.
However, although informed consent is a central tenet of medicine, it is often not practiced. In the informed consent category, home birth ranked 9.9/10 and hospital- and obstetrician-directed care ranked 4.2/10.
At least 27 of the study participants experienced an unwanted procedure without seeking informed consent or explicit consent from their healthcare provider.
Hospital policies and regulations tended to promote undesirable procedures that mothers repeatedly felt they had to avoid or felt victimized.
The women felt that what was happening to them in the hospital was happening, and they weren’t an important part of the process.
Hospital policies often took precedence over my own choices. Some reported being treated with disrespect, and were made to feel they could not trust their birth decisions.
In contrast, during home births, mothers reported feeling empowered and confident in making decisions.
joyful childbirth
Nearly all participants expressed feelings of safety, security, relaxation, comfort, or enjoyment during the homebirth experience.
They expressed that they felt trusted and respected by those who attended the birth. In fact, home birth ranked as a positive life experience for all but one participant.
This also contrasted with the participants’ hospital experience. The hospital experience was mainly described using negative language. Shameful, inhuman, disrespectful and even traumatic.
When positive words were used to describe the hospital birth experience, they were relatively unenthusiastic: ‘good’, ‘good’, ‘standard’, ‘meets expectations’ ”
For the mothers surveyed, home birth was far more positive and empowering than hospital birth. At best, their hospital experience was “meeting expectations” but “inhuman.” At its worst, hospital births were traumatic and dehumanizing.
main point
Dr. Colin Lin is a Northern California-based Family Physician who has delivered over 100 babies within the Reading Hospital system.
He believes that if doctors take the time to listen to mothers, give genuine informed consent, and support mothers during pregnancy and birth, the experience of childbirth within the hospital system will improve. I believe it will be much more positive.
“Patients are always experts,” said Lynn. “Rather than belittle or ignore her, we need to include her in all aspects of the birthing process. Doctors rarely actually work with their patients. Create systems to avoid risks. But I lost sight of the human side.”
Lynn said she has been involved in both high-risk and natural births. As he entered the delivery room, a completely naked woman in labor crouched in a warrior pose. As a young doctor, he had never seen a woman work like that.
“We’re taught to let them work with their backs,” Lynn said. , and it turned out to be a good example of what she wanted.
Lynn also said that childbirth doesn’t have to be scary and can actually be euphoric. It is often changed to a simple surgical procedure or even a vaginal birth.”
One way to improve care in the hospital setting is to encourage doctors and hospital midwives to build relationships between themselves and pregnant women, according to Lynn, who reviewed this study but was not involved in the study. to work hard for Another of hers is to improve the power imbalance between her facility and pregnant women by giving birthing women more say in their care.
“In the light of these findings, it is clear that the entire obstetric care system can be improved through better implementation of social models to increase women’s and people’s satisfaction with their childbirth experience in a hospital setting.” The researcher writes
In other words, researchers believe that women’s childbirth experiences would be more positive if a more natural, patient-centered model of childbirth was more fully implemented in a hospital setting.
Women continue to give birth in hospitals. And caregivers who are respectful, responsive, and empathetic can enhance feelings of empowerment and joy during childbirth.
Views expressed in this article are those of the author and do not necessarily reflect those of The Epoch Times. Epoch Health welcomes both professional and friendly discussion. To submit an opinion, please follow these guidelines and submit using this form.
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