School of Nursing and Midwifery, Locked Bag 1797, Penrith South, NSW 2751, Australia.
Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith South, NSW 2751, Australia.
Women Birth. 2021 Jul;34(4):396-404. doi: 10.1016/j.wombi.2020.06.005. Epub 2020 Jul 4.
In Australia there have been regulatory and insurance changes negatively affecting homebirth.
The aim of this study is to explore the characteristics, needs and experiences of women choosing to have a homebirth in Australia.
A national survey was conducted and promoted through social media networks to women who have planned a homebirth in Australia. Data were analysed to generate descriptive statistics.
1681 surveys were analysed. The majority of women indicated a preference to give birth at home with a registered midwife. However, if a midwife was not available, half of the respondents indicated they would give birth without a registered midwife (freebirth) or find an unregistered birthworker. A further 30% said they would plan a hospital or birth centre birth. In choosing homebirth, women disclosed that they wanted to avoid specific medical interventions and the medicalised hospital environment. Nearly 60% of women reported at least one risk factor that would have excluded them from a publicly funded homebirth programme. Many women described their previous hospital experience as traumatic (32%) and in some cases, leading to a diagnosis of post-traumatic stress disorder (PTSD, 6%). Only 5% of women who reported on their homebirth experience considered it to be traumatic (PTSD, 1%). The majority of these were associated with how they were treated when transferred to hospital in labour.
There is an urgent need to expand homebirth options in Australia and humanise mainstream maternity care. A potential rise in freebirth may be the consequences of inaction.
在澳大利亚，监管和保险方面的变化对家庭分娩产生了负面影响。
本研究旨在探讨选择在澳大利亚在家分娩的妇女的特征、需求和经验。
通过社交媒体网络对计划在澳大利亚在家分娩的妇女进行了全国性调查，并对其进行了推广。对数据进行了分析，以生成描述性统计数据。
分析了 1681 份调查。大多数女性表示希望在家中由注册助产士分娩。但是，如果没有助产士，一半的受访者表示他们将在没有注册助产士的情况下（自由分娩）或寻找未注册的分娩工作者分娩。另有 30%的人表示他们将计划在医院或分娩中心分娩。在选择家庭分娩时，女性表示她们希望避免特定的医疗干预措施和医院环境的医疗化。近 60%的女性报告至少有一个风险因素会使她们无法参加公共资助的家庭分娩计划。许多女性描述了她们以前在医院的经历是创伤性的（32%），在某些情况下，导致创伤后应激障碍（PTSD，6%）的诊断。只有 5%报告家庭分娩经历的女性认为这是创伤性的（PTSD，1%）。其中大多数与她们在分娩时转移到医院时的待遇有关。
澳大利亚迫切需要扩大家庭分娩的选择，并使主流产妇护理人性化。如果不采取行动，自由分娩的人数可能会增加。
