Challenging the status quo: Women's experiences of opting for a home birth in Andalucia, Spain. (March 2019)

• Record Type: Journal Article
• Authors: Leon-Larios, Fatima; Nuno-Aguilar, Cristina; Rocca-Ihenacho, Lucia; Castro-Cardona, Felipe; Escuriet, Ramon
• Is Part Of: Midwifery. Volume 70(2019)
• Page Start: 15
• Page End: 21
• Publication Date: 2019-03
• Subjects: Home birth -- Midwives -- Private practice -- Midwifery-led care -- Phenomenological approach -- Qualitative methodology; Midwifery -- Periodicals; Midwifery -- Periodicals; Sages-femmes -- Périodiques; Midwifery; Periodicals; Electronic journals; 618.2005
• DOI: 10.1016/j.midw.2018.12.001
• Languages: English
• ISSNs: 0266-6138

Abstract

Highlights: Despite strong evidence supporting choice of birth place for healthy women with uncomplicated pregnancies, this study reports a serious lack of choice regarding birth place in Spain. National policy in support of different birth places is urgently needed in Spain. Women felt judged by healthcare providers for their place of birth choice and did not feel supported when an intrapartum transfer was required. All healthcare professionals, irrespective of where they are based – in a hospital or community setting - should acknowledge and respect women's needs and rights for personalised care, privacy and self-determination: this includes how and where to give birth. Abstract: Objective: To explore the perceptions, beliefs and attitudes of women who opted for a home birth in Andalusia (Spain). Background: Home birth is currently an unusual choice among Spanish women. It is not an option covered by the Spanish National Health Service and women who opt for a home birth have to pay for an independent midwife. Design: A qualitative study with a phenomenological approach was adopted. All participants who took part in this study had chosen to have a home birth and given written consent to take part in the study. Methods: Data collection was conducted in 2015–16. Face-to-face, semi-structured interviews were undertaken with women who chose a home birth in the last 5 years. Findings: The sample consisted of thirteen women. Seven themes were created through analysis: 1. Getting informed about home birth; 2. Home birth as a choice, despite feeling unsupported; 3. The best way to have a personalized and a physiological birth; 4. Seeking a healing and empowering experience 5. The need for emotional safety, establishing a relationship and trusting the midwife; 6. Preparing for birth and working on fears; 7. Inequality of access (because of financial implications). Conclusions: Women opted to plan birth at home because they wanted a personalised birth and control over their decision-making in labour, which they felt would not have been afforded to them in hospital settings. Andalusian maternity care leaders should strive to ensure that all pregnant women receive respectful and high-quality personalised care, by appropriately trained staff, both in the hospital and in the community.