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Relationships are the key to a successful publicly funded homebirth program, a qualitative study

Published:January 03, 2023DOI:https://doi.org/10.1016/j.wombi.2022.12.005

      Abstract

      Background

      In Australia, publicly-funded homebirth is a relatively new option for women and their families. Two years after the inception of two publicly funded homebirth services in Victoria in 2009, a study found that midwives’ experiences were more positive than doctors. There is no recent evidence on the perspectives of midwives and doctors of publicly-funded homebirth programs.

      Aim

      To explore the experiences of midwives and doctors participating in or supporting one publicly-funded homebirth program in Australia.

      Methods

      An interpretive descriptive approach was used following individual in-depth interviews via ‘Zoom’. Participants included midwives and doctors who provide or support the homebirth service at a large metropolitan health service in Melbourne’s western suburbs. Data were thematically analysed.

      Findings

      Interviews were conducted with 16 homebirth midwives, six hospital-based midwives, and nine doctors. One central theme and three sub-themes demonstrate that effective relationships are critical to a successful publicly-funded homebirth program. Collaboration, teamwork, and mutual respect across professions were reported to be integral to success. The midwife-woman relationship was highly valued and especially important to provide continuity during transfers to the hospital where this occurred.

      Discussion

      Effective relationships underpin collaborative practice and are critical for safe healthcare. Shared common learning opportunities such as simulation training sessions and multi-professional forums to discuss cases were perceived to assist the development of these relationships.

      Conclusion

      Effective relationships within and between midwives and doctors are key to collaborative practice, which underpins a successful publicly-funded homebirth service. Health services can support this by maintaining a respectful and supportive culture amongst staff.

      Abbreviations:

      PPM (privately practicing midwife), MGP (Midwifery Group Practice), HBM (homebirth midwife), MC (midwifery core staff in the birth suite), DOC (doctor)

      Keywords

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