Abstract
Problem
Eligibility criteria for publicly-funded homebirth models are strict and, as such,
many women who initially plan a homebirth later become excluded.
Background
Fifteen publicly-funded homebirth programs are operating in Australia, offering eligible
women the opportunity to give birth at home at no cost, with the care of a hospital-employed
midwife.
Aim
To explore the experiences of women who planned a publicly-funded homebirth and were
later excluded due to pregnancy complications or risk factors.
Methods
A qualitative descriptive approach was taken. Recruitment was via social media sites
specifically related to homebirth in Australia. Data collection involved semi-structured
telephone interviews. Transcripts were thematically analysed.
Findings
Thirteen women participated. They were anxious about ‘Jumping through hoops’ to maintain
their low-risk status. After being ‘Kicked off the program’, women carefully 'negotiated
the system’ in order to get the birth they wanted in hospital. Some women felt bullied
and coerced into complying with hospital protocols that did not account for their
individual needs. Maintaining the midwife-woman relationship was a protective factor,
decreasing negative experiences.
Discussion
Women plan a homebirth to avoid the medicalised hospital environment and to gain access
to continuity of midwifery care. To provide maternity care that is acceptable to women,
hospital institutions need to design services that enable continuity of the midwife-woman
relationship and assess risk on an individual basis.
Conclusion
Exclusion from publicly-funded homebirth has the potential to negatively impact women
who may feel a sense of loss, uncertainty or emotional distress related to their planned
place of birth.
Keywords
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Article info
Publication history
Published online: June 25, 2022
Accepted:
June 20,
2022
Received in revised form:
June 9,
2022
Received:
December 16,
2021
Identification
Copyright
© 2022 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
