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1.
Rev. enferm. UERJ ; 29: e56113, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224567

RESUMO

Objetivo: descrever a escolha do parto domiciliar planejado acompanhado por enfermeira obstétrica em um centro urbano de grande porte, na perspectiva de mulheres brasileiras. Métodos: estudo qualitativo guiado pela Grounded Theory. Foram entrevistadas dez mulheres com idade entre 20 e 41 anos que tiveram parto domiciliar planejado acompanhadas por enfermeiras obstétricas. As participantes foram recrutadas por meio de rede social, acessando um grupo de mulheres que escreveram sobre seu parto domiciliar. Resultados: Emergiram duas categorias: Não vendo possibilidade de parir naturalmente no ambiente hospitalar e Pensando na segurança do parto domiciliar planejado. O hospital representou vários aspectos desfavoráveis como intervenções desnecessárias e solidão. As mulheres consideravam o lar um lugar seguro para parir, conectado aos cuidados de enfermeiras obstétricas. Conclusão: há mulheres que não desejam parir no hospital, preferindo parir em casa e do ponto de vista dos direitos humanos e dos cuidados desmedicalizados, as enfermeiras obstétricas devem apoiar as mulheres nessa sua decisão.


Objective: to describe the choice of planned homebirth attended by a nurse midwife in a large urban centre, from the perspective of Brazilian women. Methods: in this Grounded Theory study, ten women aged 20 to 41 years, who had a planned homebirth accompanied by a nurse midwife, were interviewed. Participants were recruited through a social network by accessing a group of women who wrote about their homebirth. Results: two categories emerged: seeing no possibility of giving birth naturally in the hospital environment; and thinking about the safety of a planned homebirth. Hospital represented several unfavourable aspects, such as unnecessary interventions and loneliness. Women thought of home as a safe place to give birth, connected with nurse midwife care. Conclusion: there are women who do not wish to give birth in hospital, but prefer to give birth at home and, from the point of view of human rights and de-medicalized care, nurse midwives should support women in their decision.


Objetivo: describir la elección del parto domiciliario planificado con enfermera obstétrica en un gran centro urbano, desde la perspectiva de mujeres brasileñas. Métodos: estudio cualitativo guiado por la Grounded Theory. Se entrevistó a diez mujeres entre 20 y 41 años que tuvieron parto domiciliario planificado, siendo acompañadas de enfermeras obstétricas. Las participantes fueron reclutadas a través de red social, accediendo a un grupo de mujeres que escribieron sobre su parto en domicilio. Resultados: surgieron dos categorías: las que no veían posibilidad de dar a luz naturalmente en el hospital y las que pensaron en la seguridad del parto domiciliario planificado. El hospital representó varios aspectos desfavorables como intervenciones innecesarias y soledad. Las mujeres consideraban que el hogar era un ambiente seguro para dar a luz, vinculado al cuidado de enfermeras obstétricas. Conclusión: hay mujeres que no desean dar a luz en el hospital, prefieren hacerlo en casa y, desde el punto de vista de los derechos humanos y de los cuidados sin la intervención de un médico, las enfermeras obstétricas deben apoyarlas en esa decisión.


Assuntos
Humanos , Feminino , Gravidez , Adulto , Parto Domiciliar/enfermagem , Parto Normal/enfermagem , Enfermeiras Obstétricas , Gestantes/psicologia , Segurança do Paciente , Parto Domiciliar/psicologia , Parto Normal/psicologia
2.
Rev. enferm. UERJ ; 29: e53642, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224513

RESUMO

Objetivo: descrever os cuidados domiciliares prestados por parteiras tradicionais durante a assistência ao parto. Método: estudo qualitativo conduzido por meio do método da História Oral Temática, realizado com 16 parteiras em nove municípios do Cariri cearense. A coleta de dados ocorreu entre julho e dezembro de 2015 por meio de entrevista semiestruturada, os relatos foram transcritos, textualizados e transcriados. Resultados: as parteiras prestavam cuidados familiares, assistência ao parto vaginal, cuidados com o recém-nascido e no puerpério imediato. Usavam chás e orações como adjuvantes do seu ofício. Conclusão: o cuidado das parteiras na assistência ao parto centralizava-se nas necessidades da mulher e da família, sendo, em alguns casos, extensivo à casa. As parteiras conheciam os sinais e sintomas do trabalho de parto e agiam nas possíveis intercorrências.


Objective: to describe home care provided by traditional midwives during childbirth care. Method: this qualitative study, using the Thematic Oral History method, was conducted with 16 midwives from nine municipalities in Cariri, Ceará. Data were collected from July to December 2015 through semi-structured interviews, the reports were transcribed, textualized and transcreated. Results: midwives provided family care, vaginal delivery care, newborn care and immediate postpartum care. They used teas and prayers as an adjuncts to their craft. Conclusion: childbirth care by midwives centered on the women's and families' needs and, in some cases, extended to the home. Midwives knew the signs and symptoms of labor and acted on possible complications.


Objetivo: describir los cuidados domiciliarios brindados por parteras tradicionales durante la atención al parto. Método: estudio cualitativo conducido mediante el método de Historia Oral Temática, realizado con 16 parteras en nueve municipios de Cariri en Ceará. La recolección de datos se realizó entre julio y diciembre de 2015 a través de entrevistas semiestructuradas; los relatos fueron transcritos, textualizados y transcreados. Resultados: las parteras brindaron atención familiar, asistencia en el parto vaginal, cuidados al recién nacido y en el puerperio inmediato. Usaban tés y oraciones como complemento de su oficio. Conclusión: el cuidado de las parteras en la atención al parto se centraba en las necesidades de la mujer y de la familia, extendiéndose, en algunos casos, al hogar. Las parteras conocían los signos y síntomas del trabajo de parto y actuaban sobre las posibles complicaciones.


Assuntos
Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Assistência Perinatal , Parto Domiciliar , Assistência Domiciliar , Tocologia , Trabalho de Parto , Pesquisa Qualitativa , Período Pós-Parto
3.
BMC Health Serv Res ; 21(1): 816, 2021 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-34391422

RESUMO

BACKGROUND: In New South Wales (NSW), Australia there are three settings available for women at low risk of complications to give birth: home, birth centre and hospital. Between 2000 and 2012, 93.6% of babies were planned to be born in hospital, 6.0% in a birth centre and 0.4% at home. Availability of alternative birth settings is limited and the cost of providing birth at home or in a birth centre from the perspective of the health system is unknown. OBJECTIVES: The objective of this study was to model the cost of the trajectories of women who planned to give birth at home, in a birth centre or in a hospital from the public sector perspective. METHODS: This was a population-based study using linked datasets from NSW, Australia. Women included met the following selection criteria: 37-41 completed weeks of pregnancy, spontaneous onset of labour, and singleton pregnancy at low risk of complications. We used a decision tree framework to depict the trajectories of these women and Australian Refined-Diagnosis Related Groups (AR-DRGs) were applied to each trajectory to estimate the cost of birth. A scenario analysis was undertaken to model the cost for 30 000 women in one year. FINDINGS: 496 387 women were included in the dataset. Twelve potential outcome pathways were identified and each pathway was costed using AR-DRGs. An overall cost was also calculated by place of birth: $AUD4802 for homebirth, $AUD4979 for a birth centre birth and $AUD5463 for a hospital birth. CONCLUSION: The findings from this study provides some clarity into the financial saving of offering more options to women seeking an alternative to giving birth in hospital. Given the relatively lower rates of complex intervention and neonatal outcomes associated with women at low risk of complications, we can assume the cost of providing them with homebirth and birth centre options could be cost-effective.


Assuntos
Centros de Assistência à Gravidez e ao Parto , Parto Domiciliar , Austrália/epidemiologia , Entorno do Parto , Feminino , Humanos , Recém-Nascido , Parto , Gravidez
4.
Health Policy Plan ; 36(9): 1428-1440, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34279643

RESUMO

Proportions of facility births are increasing throughout sub-Saharan Africa, but obstetric services vary within the health system. In Tanzania, advanced management of childbirth complications (comprehensive emergency obstetric care) is offered in hospitals, while in frontline, primary health care (PHC) facilities (health centres and dispensaries) mostly only routine childbirth care is available. With over half (54%) of rural births in facilities, we hypothesized the presence of socio-economic inequity in hospital-based childbirth uptake in rural Tanzania and explored whether this relationship was modified by parity. This inequity may compound the burden of greater mortality among the poorest women and their babies. Records for 4456 rural women from the 2015-16 Tanzania Demographic and Health Survey with a live birth in the preceding 5 years were examined. Proportions of births at each location (home/PHC/hospital) were calculated by demographic and obstetric characteristics. Multinomial logistic regression was used to obtain crude and adjusted odds ratios of home/PHC and hospital/PHC births based on household wealth, including interaction between wealth and parity. Post-estimation margins analysis was applied to estimate childbirth location by wealth and parity. Hospital-based childbirth uptake was inequitable. The gap between poorest and richest was less pronounced at first birth. Hospital-based care utilization was lowest (around 10%) among the poorest multiparous women, with no increase at high parity (≥5) despite higher risk. PHC-based childbirth care was used by a consistent proportion of women after the first birth (range 30-51%). The poorest women utilized it at intermediate parity, but at parity ≥5 mostly gave birth at home. In an effort to provide effective childbirth care to all women, context-specific strategies are required to improve hospital-based care use, and poor, rural, high parity women are a particularly vulnerable group that requires specific attention. Improving childbirth care in PHC and strengthening referral linkages would benefit a considerable proportion of women.


Assuntos
Parto Domiciliar , Serviços de Saúde Materna , Parto Obstétrico , Demografia , Feminino , Acesso aos Serviços de Saúde , Hospitais , Humanos , Gravidez , População Rural , Tanzânia
6.
PLoS One ; 16(6): e0252735, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34138877

RESUMO

BACKGROUND AND OBJECTIVE: During the COVID-19 pandemic the organization of maternity care changed drastically; this study into the experiences of maternity care professionals with these changes provides suggestions for the organization of care during and after pandemics. DESIGN: An online survey among Dutch midwives, obstetricians and obstetric residents. Multinomial logistic regression analyses were used to investigate associations between the respondents' characteristics and answers. RESULTS: Reported advantages of the changes were fewer prenatal and postpartum consultations (50.1%). The necessity and safety of medical interventions and ultrasounds were considered more critically (75.9%); 14.8% of community midwives stated they referred fewer women to the hospital for decreased fetal movements, whereas 64.2% of the respondents working in hospital-based care experienced fewer consultations for this indication. Respondents felt that women had more confidence in giving birth at home (57.5%). Homebirths seemed to have increased according to 38.5% of the community midwives and 65.3% of the respondents working in hospital-based care. Respondents appreciated the shift to more digital consultations rather than face-to-face consultations. Mentioned disadvantages were that women had appointments alone, (71.1%) and that the community midwife was not allowed to join a woman to obstetric-led care during labour and subsequently stay with her (56.8%). Fewer postpartum visits by family and friends led to more tranquility (59.8%). Overall, however, 48.0% of the respondents felt that the safety of maternity care was compromised due to policy changes. CONCLUSIONS: Maternity care professionals were positive about the decrease in routine care and the increased confidence of women in home birth, but also felt that safety in maternity care was sometimes compromised. According to the respondents in a future crisis situation it should be possible for community midwives to continue to deliver a personal handover after the referral of women to the hospital, and to stay with them.


Assuntos
COVID-19/prevenção & controle , Serviços de Saúde Materna/estatística & dados numéricos , Tocologia/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , SARS-CoV-2/isolamento & purificação , Adulto , COVID-19/epidemiologia , COVID-19/virologia , Feminino , Parto Domiciliar/métodos , Parto Domiciliar/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Humanos , Trabalho de Parto , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Países Baixos , Gravidez , Cuidado Pré-Natal/métodos , SARS-CoV-2/fisiologia , Inquéritos e Questionários/estatística & dados numéricos
8.
Am Fam Physician ; 103(11): 672-679, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34060788

RESUMO

Since the 1970s, most births in the United States have been planned to occur in a hospital. However, a small percentage of Americans choose to give birth outside of a hospital. The number of out-of-hospital births has increased, with one in every 61 U.S. births (1.64%) occurring out of the hospital in 2018. Out-of-hospital (or community) birth can be planned or unplanned. Of those that are planned, most occur at home and are assisted by midwives. Patients who choose a planned community birth do so for multiple reasons. International observational studies that demonstrate comparable outcomes between planned out-of-hospital and planned hospital birth may not be generalizable to the United States. Most U.S. studies have found statistically significant increases in perinatal mortality and neonatal morbidity for home birth compared with hospital birth. Conversely, planned community birth is associated with decreased odds of obstetric interventions, including cesarean delivery. Perinatal outcomes for community birth may be improved with appropriate selection of low-risk, vertex, singleton, term pregnancies in patients who have not had a previous cesarean delivery. A qualified, licensed maternal and newborn health professional who is integrated into a maternity health care system should attend all planned community births. Family physicians are uniquely poised to provide counseling to patients and their families about the risks and benefits associated with community birth, and they may be the first physicians to evaluate and treat newborns delivered outside of a hospital.


Assuntos
Entorno do Parto , Centros de Assistência à Gravidez e ao Parto , Parto Domiciliar , Entorno do Parto/tendências , Centros de Assistência à Gravidez e ao Parto/normas , Centros de Assistência à Gravidez e ao Parto/tendências , Feminino , Parto Domiciliar/efeitos adversos , Parto Domiciliar/métodos , Parto Domiciliar/tendências , Humanos , Recém-Nascido , Tocologia/normas , Tocologia/tendências , Participação do Paciente , Segurança do Paciente , Seleção de Pacientes , Assistência Perinatal/métodos , Assistência Perinatal/normas , Guias de Prática Clínica como Assunto , Gravidez , Medição de Risco , Estados Unidos
9.
Health Policy Plan ; 36(9): 1441-1450, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34139011

RESUMO

Increasing facility-based delivery rates is pivotal to reach Sustainable Development Goals to improve skilled attendance at birth and reduce maternal and neonatal mortality in low- and middle-income countries (LMICs). The translation of global health initiatives into national policy and programmes has increased facility-based deliveries in LMICs, but little is known about the impact of such policies on social norms from the perspective of women who continue to deliver at home. This qualitative study explores the reasons for and experiences of home delivery among women living in rural Zimbabwe. We analysed qualitative data from 30 semi-structured interviews and 5 focus group discussions with women who had delivered at home in the previous 6 months in Mashonaland Central Province. We found evidence of strong community-level social norms in favour of facility-based delivery. However, despite their expressed intention to deliver at a facility, women described how multiple, interacting vulnerabilities resulted in delivery outside of a health facility. While identified as having delivered 'at home', narratives of birth experiences revealed the majority of women in our study delivered 'on the road', en route to the health facility. Strong norms for facility-based delivery created punishments and stigmatization for home delivery, which introduced additional risk to women at the time of delivery and in the postnatal period. These consequences for breaking social norms promoting facility-based delivery for all further increased the vulnerability of women who delivered at home or on the road. Our findings highlight that equitable public health policy and programme designs should include efforts to actively identify, mitigate and evaluate unintended consequences of social change created as a by-product of promoting positive health behaviours among those most vulnerable who are unable to comply.


Assuntos
Parto Domiciliar , Serviços de Saúde Materna , Parto Obstétrico , Feminino , Grupos Focais , Instalações de Saúde , Humanos , Recém-Nascido , Gravidez , Pesquisa Qualitativa , População Rural , Normas Sociais , Zimbábue
10.
Afr J Reprod Health ; 25(1): 20-28, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34077107

RESUMO

Over the past 30 years, the Moroccan government has made enormous strides towards improving maternal health care for Moroccan women, but outcomes for rural women remain much worse than those of their urban counterparts. This study aimed to understand the experiences of women giving birth in rural Morocco, and to identify the barriers they face when accessing facility-based maternity care. Fifty-five participants were recruited from villages in Morocco's rural south to participate in focus group discussions (FGDs), using appreciative inquiry as the guiding framework. Several themes emerged from the analysis of the focus group data. Women felt well-cared for and safe giving birth both at home and in the large, tertiary care hospitals, but not in the small, primary care hospitals. Women who gave birth at the primary care hospitals reported a shortage of some equipment and supplies and poor treatment at the hands of hospital staff. Locating and paying for transportation was identified as the biggest hurdle in accessing maternity care at any hospital. The findings of this study indicate the need for change within primary care health facilities.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde , Serviços de Saúde Materna/organização & administração , Serviços de Saúde Materna/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Atitude do Pessoal de Saúde , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Parto Domiciliar , Humanos , Saúde Materna , Tocologia , Gravidez , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , População Rural
11.
Rev Bras Enferm ; 74(4): e20200404, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34105640

RESUMO

OBJECTIVE: To understand how information about Planned Home Birth motivates or discourages women's decisions on this location of birth. METHOD: Descriptive exploratory study, qualitative approach. Data collection carried out from February to April 2019, through semi-structured interviews with 14 women and documentary sources. The data were analyzed using Bardin's content analysis process, with the help of ATLAS.ti 8.0. RESULTS: The motivations for choosing Planned Home Birth are: respect for the autonomy and natural process of childbirth and delivery, support from a partner and trust in professionals. Aspects that discourage this choice are fear of complications, the need for a hospital medical structure, opinions that value risk. CONCLUSION: Women's choices are based not only on information, but also on how that information is processed. This study demonstrated that the perception pertaining to the safety of Planned Home Birth is essential for making this decision.


Assuntos
Comportamento de Escolha , Tomada de Decisões , Parto Domiciliar , Motivação , Adulto , Feminino , Humanos , Entrevistas como Assunto , Parto , Gravidez , Pesquisa Qualitativa
12.
PLoS One ; 16(5): e0250702, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33945560

RESUMO

Home birth is very common in the Peruvian Amazon. In rural areas of the Loreto region, home to indigenous populations such as the Kukama-Kukamiria, birth takes place at home constantly. This study aims to understand the preference for home births as well as childbirth and newborn care practices among Kukama-Kukamiria women in rural Loreto. Following a case study approach, sixty semi-structured, face-to-face interviews were conducted with recent mothers who experienced childbirth within one year prior to the interview, female relatives of recent mothers who had a role in childbirth, male relatives of recent mothers, community health workers, and traditional healers. We found that for women from these communities, home birth is a courageous act and an intimate (i.e. members of the community and relatives participate in it) and inexpensive practice in comparison with institutional birth. These preferences are also linked to experiences of mistreatment at health facilities, lack of cultural adaptation of birthing services, and access barriers to them. Preparations for home births included handwashing and cleaning delivery surfaces. After birth, waiting for the godparent to arrive to cut the cord can delay drying of the newborn. Discarding of colostrum, lack of skin-to-skin contact as well as a range of responses regarding immediate breastfeeding and immediate drying of the baby were also found. These findings were used to tailor the educational content of the Mamas del Rio program, where community health workers are trained to identify pregnancy early, perform home visits to pregnant women and newborns, and promote essential newborn care practices in case institutional birth is not desired or feasible. We make recommendations to improve Peru's cultural adaptation of birthing services.


Assuntos
Parto Domiciliar/estatística & dados numéricos , Cuidado do Lactente/estatística & dados numéricos , Parto , População Rural/estatística & dados numéricos , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Recém-Nascido , Peru , Gravidez , Fatores Socioeconômicos , Adulto Jovem
14.
PLoS One ; 16(4): e0249224, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33886560

RESUMO

BACKGROUND: Birth cultures have been transforming in recent years mainly affecting birth care and its socio-political contexts. This situation has affected the feeling of well-being in women at the time of giving birth. AIM: For this reason, our objective was to analyse the social meaning that women ascribe to home births in the Chilean context. METHOD: We conducted thirty semi-structured interviews with women living in diverse regions ranging from northern to southern Chile, which we carried out from a theoretical-methodological perspective of phenomenology and situated knowledge. Qualitative thematic analysis was used to analyse the information collected in the field work. FINDINGS: A qualitative thematic analysis produced the following main theme: 1) Home birth journeys. Two sub-categories: 1.1) Making the decision to give birth at home, 1.2) Giving birth: (re)birth. And four sub-categories also emerged: 1.1.1) Why do I need to give birth at home? 1.1.2) The people around me don't support me; 1.2.1) Shifting emotions during home birth, 1.2.2) I (don't) want to be alone. CONCLUSION: We concluded that home births involve an intense and diverse range of satisfactions and tensions, the latter basically owing to the sociocultural resistance surrounding women. For this reason, they experienced home birth as an act of protest and highly valued the presence of midwives and their partners.


Assuntos
Parto Domiciliar/psicologia , Mães/psicologia , Adulto , Chile , Diversidade Cultural , Feminino , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Tocologia , Gravidez , Cônjuges/psicologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-33916388

RESUMO

Previous studies have shown that planned home birth in low-risk pregnancies is a generally safe option. However nowadays, only 0.5 percent of deliveries have been at home in Spain. This study sought to understand the characteristics of planned home births with qualified healthcare professionals in low-risk pregnancies and their results on maternal and neonatal health in the Balearic Islands. The study followed a retrospective descriptive design to investigate planned home births from 1989 to 2019 (n = 820). Sociodemographic data of women, healthcare professional intervention rates, and maternal/fetal morbidity/mortality results were collected. Statistical analysis of the results was performed using the IBM SPSS Version 25 software package. The results indicated that women with low-risk pregnancies who planned home births with a qualified midwife had a higher probability of spontaneous vaginal birth delivery and positive maternal health results. Furthermore, the risk of hospital transfer was low (10.7%) and the rate of prolonged breastfeeding (>1 year) was extremely high (99%). Moreover, the study showed that planned home births can be generally associated with fetal well-being. The conclusions and implications of this study are that planned home births in low-risk pregnancies attended by qualified midwives in the Balearic Islands achieve positive results in both maternal and newborn health, as well as low rates of obstetric intervention.


Assuntos
Parto Domiciliar , Tocologia , Parto Obstétrico , Feminino , Humanos , Recém-Nascido , Gravidez , Estudos Retrospectivos , Espanha
16.
Pan Afr Med J ; 38: 90, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33889256

RESUMO

Introduction: decision making is a vital aspect of women's reproductive life. In an attempt to fulfil the desire to procreate, women's lives are lost especially in developing countries where medical care is still inadequate. The researchers sought to explore the Hausa people's culture as regards maternal health choices concerning modern family planning methods, delivery places and parity. Methods: a cross-sectional study using mixed methods was conducted among women of reproductive age (N=253) in three Hausa communities in Ibadan. Based on the objectives, semi-structured questionnaire and in-depth interview guide were used for data collection. Quantitative data were analysed using Chi-square and the level significance set at 0.05 while qualitative data were analysed thematically. Results: over fifty percent respondents had more than 3 children and about one third (33.9%) preferred having more than 4 children. Nearly all participants (94%) were aware of modern family planning methods but only 49.0% used them. The most widely used methods are injectables (22.0%) and condoms (20.6%). Almost half of the study population (46.5%) delivered their babies at home with assistance from other residents with most preferring home delivery for various reasons. Conclusion: although the level of awareness about family planning methods is quite satisfactory, however, the level of contraceptive uptake is still sub-optimal. Most Hausa women prefer home delivery which predisposes them to associated complications. Findings further identified various reasons for maternal health choices and provided insights on viable nursing interventions that can be adopted to promote skilled birth delivery to reduce maternal morbidity and mortality.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Serviços de Planejamento Familiar/estatística & dados numéricos , Saúde Materna/etnologia , Adolescente , Adulto , Comportamento Contraceptivo/etnologia , Anticoncepcionais/uso terapêutico , Estudos Transversais , Tomada de Decisões , Feminino , Parto Domiciliar/estatística & dados numéricos , Humanos , Nigéria , Gravidez , Inquéritos e Questionários , Adulto Jovem
17.
Birth ; 48(2): 242-250, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33677838

RESUMO

BACKGROUND: The COVID-19 pandemic introduced unparalleled uncertainty into the lives of pregnant women, including concerns about where it is the safest to give birth, while preserving their rights and wishes. Reports on the increased interest in community births (at home or in birth centers) are emerging. The purpose of this project was to quantitatively investigate psychological factors related to this birth preference. METHODS: This study included 3896 pregnant women from the COVID-19 Pregnancy Experiences (COPE) Study who were anticipating a vaginal birth. COPE Study participants were recruited online between April 24 and May 15, 2020, and completed a questionnaire that included preference with respect to place of birth and psychological constructs: fear of childbirth, basic beliefs about birth, pandemic-related preparedness stress, and pandemic-related perinatal infection stress. RESULTS: Women who preferred a community birth, on average, had less childbirth fear, had stronger beliefs that birth is a natural process, were less likely to see birth as a medical process, and were less stressed about being unprepared for birth and being infected with COVID-19. In multivariate models, higher stress about perinatal COVID-19 infection was associated with greater likelihood of preferring a community birth. The effect of perinatal infection stress on preference was stronger when preparedness stress was high. DISCUSSION: Women's birth preferences during the COVID-19 pandemic are associated with psychological processes related to risk perception. Community births are more appealing to women who view being in a hospital as hazardous because of the pandemic. Policies and prenatal care aimed to increase access to safe in-hospital and out-of-hospital birth services should be encouraged.


Assuntos
Centros de Assistência à Gravidez e ao Parto/estatística & dados numéricos , COVID-19 , Parto Domiciliar/estatística & dados numéricos , Parto/psicologia , Complicações na Gravidez , Estresse Psicológico , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Medo , Feminino , Humanos , Preferência do Paciente/psicologia , Preferência do Paciente/estatística & dados numéricos , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/etiologia , Gestantes/psicologia , SARS-CoV-2 , Percepção Social , Estresse Psicológico/diagnóstico , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Incerteza
18.
J Midwifery Womens Health ; 66(2): 256-264, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33710761

RESUMO

INTRODUCTION: Skilled care is indicated as a measure to prevent the deaths of pregnant women across sub-Saharan Africa. Despite this, many women continue to give birth at home. There has been little attention as to how the experience of intimate partner violence (IPV) or autonomous decision-making about place of birth influences home births in rural Zambia. This study explores how markers of sociocultural gender inequities (prevalence of IPV and autonomous decision-making) correlate with home birth in rural Zambia. METHODS: This secondary analysis uses quantitative data from a baseline household survey with women who had given birth within the past 13 months in rural Zambia. Control variables shown to be significant in the literature were included in the model, and binary logistic regression was used to assess the influence of IPV and autonomous decision-making on home birth. RESULTS: This sample included 2381 women from rural Zambia, of whom 384 reported a home birth within the past 13 months. Women who were autonomously making the decision about where to give birth were more likely to have a home birth (adjusted odds ratio [AOR], 1.729; SE, 0.210; 95% CI, 1.362-2.194; P < .001). Self-report of experiencing physical IPV in the past 2 weeks was not significant in predicting home birth (AOR, 0.783; SE, 0.181; 95% CI, 0.496-1.234; P = .293). Women who self-identified as Tumbuka or other, were able to afford school fees, had completed secondary education or higher, were married, and had 4 or more antenatal care visits were significantly less likely to report a home birth. DISCUSSION: This quantitative analysis did not corroborate findings from other research that implicates IPV as a predictor of home birth. Additionally, autonomous decision-making was not associated with a decrease in home births. Future work should incorporate qualitative or mixed methods strategies to comprehensively explore household- and facility-level interventions to promote facility birth.


Assuntos
Parto Domiciliar , Violência por Parceiro Íntimo , Feminino , Humanos , Gravidez , Gestantes , População Rural , Zâmbia
20.
Pediatr. catalan ; 81(1): 7-13, ene.-mar. 2021. graf, mapas
Artigo em Espanhol | IBECS | ID: ibc-202628

RESUMO

El part domiciliari planificat, assistit per professionals competents I coordinades amb el sistema de salut, ha demostrat ser tan segur com el part hospitalari en gestants de baix risc. El part domiciliari a Catalunya ha esdevingut, els darrers trenta anys, l'única opció per a moltes dones d'evitar l'alt nivell d'intervencionisme en l'atenció al part hospitalari. Aquest treball revisa la bibliografia sobre el part a casa I explora I reflexiona sobre diferents aspectes de la seva situació a Catalunya. L'evidència deixa clar que amb bones guies d'actuació I sistemes de trasllat ben establerts, hi ha poc o cap risc incrementat associat directament al part domiciliari. Tanmateix, per garantir-ne la seguretat cal l'accés a l'atenció mèdica I hospitalària. La col·laboració entre tots els professionals del naixement és essencial per oferir una atenció integral que preservi els interessos de les mares I els nounats perquè el part I el naixement siguin segurs per a unes I altres, saludables a tots els nivells I satisfactoris per a tota la família. A Catalunya, cinc per cada mil dones pareixen a casa. Atès que la dona és lliure de triar on vol parir, que ho faci en les condicions òptimes de seguretat depèn de la col·laboració de tots els professionals implicats en l'atenció a les dones I els nounats, així com de les institucions responsables de la salut. L'Associació de Llevadores del Part a Casa de Catalunya (ALPACC) vol treballar, juntament amb obstetres I neonatòlegs/neonatòlogues, per aconseguir aquesta collaboració interprofessional I institucional


El parto domiciliario planificado, asistido por profesionales compe-tentes y coordinadas con el sistema de salud, ha demostrado ser tan seguro como el parto hospitalario en gestantes de bajo riesgo. El parto domiciliario en Cataluña ha sido, los últimos treinta años, la única opción para muchas mujeres de evitar el alto nivel de intervencionismo en la atención al parto hospitalario. Este trabajo revisa la bibliografía sobre el parto en casa, y explora y reflexiona sobre diferentes aspectos de su situación en Cataluña. La evidencia deja claro que, con buenas guías de actuación y sistemas de traslado bien establecidos, hay poco o ningún riesgo incrementado asociado directamente con el parto domiciliario. Sin embargo, para garantizar su seguridad, es necesario el acceso a la atención médica y hospitalaria. La colaboración entre todos los profesionales del nacimiento es esencial para ofrecer una atención integral que preserve los intereses de las madres y los recién nacidos para que el parto y el nacimiento sean seguros para ambos, saludable a todos los niveles y satisfactorio para toda la familia. En Cataluña, cinco por cada mil mujeres paren en casa. Dado que la mujer es libre de elegir dónde quiere parir, que lo haga en las condiciones óptimas de seguridad depende de la colaboración de todos los profesionales implicados en la atención a las mujeres y los recién nacidos, así como de las instituciones sanitarias. La Associació de Llevadores del Part a Casa de Catalunya (ALPACC) quiere trabajar, conjuntamente con obstetras y neonatólogos/ neonatólogas, para conseguir esta colaboración interprofesional e institucional


Well-planned home birth, assisted by trained professionals and coordinated with the health systems, has demonstrated to be as safe as hospital birth for low-risk pregnancies. Over the last 30 years in Catalonia, home birth has been the only option for women who want to avoid the high level of interventionism that characterizes hospital birth. In this article, we review the literature on home birth, and we examine its status in Catalonia. Available evidence indicates that with good management guides and well-established transportation systems, the incremental risk associated with home birth is minimal. However, in order to ensure safety, ready access to medical and hospital care is critical. The collaboration between all professionals is essential to offer comprehensive care that protects the interests and well-being of the mothers and the newborn, with the goal of creating a safe and healthy birth experience for both and to the satisfaction of the family. In Catalonia, five of every thousand females deliver at home. Given the fact that women can chose where they want to deliver, having the optimum conditions of safety depends on the collaboration of all the healthcare providers dedicated to maternal and child health, as well as the healthcare administration. The Association of Home Birth Midwives of Catalonia wants to work together with obstetricians and neonatologists to achieve this interprofessional and institutional collaboration


Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Adulto , Parto Domiciliar/estatística & dados numéricos , Tocologia , Segurança do Paciente , Assistência Perinatal/estatística & dados numéricos , Enfermeiras Obstétricas/estatística & dados numéricos , Neonatologistas/estatística & dados numéricos , Sistemas de Saúde/normas , Espanha , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Garantia da Qualidade dos Cuidados de Saúde/estatística & dados numéricos , Assistência Perinatal , Morte Perinatal/prevenção & controle , Comunicação Interdisciplinar
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