Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada.
McMaster Midwifery Research Centre, Department of Obstetrics and Gynecology, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Syst Rev. 2021 Nov 2;10(1):291. doi: 10.1186/s13643-021-01837-9.
Home birth is experienced by people very differently worldwide. These experiences likely differ by the type of stakeholder involved (women, their support persons, birth attendants, policy-makers), the experience itself (low-risk birth, transfer to hospital, previous deliveries), and by the health system within which home birth occurs (e.g., high-resource versus low- and middle-resource countries). Research evidence of stakeholders' perspectives of home birth could usefully inform personal and policy decisions about choosing and providing home birth, but the current literature is fragmented and its breadth is not fully understood.We conducted a systematic scoping review to understand how the research literature on stakeholders' perspectives of home birth is characterized in terms of populations, settings and identified issues, and what potential gaps exist in the research evidence. A range of electronic, web-based and key informant sources of evidence were searched. Located references were assessed, data extracted, and descriptively analyzed using robust methods.Our analysis included 460 full reports. Findings from 210 reports of studies in high-resource countries suggested that research with fathers and same-sex partners, midwives, and vulnerable populations and perspectives of freebirth and transfer to hospital could be synthesized. Gaps in primary research exist with respect to family members, policy makers, and those living in rural and remote locations. A further 250 reports of studies in low- and middle-resource countries suggested evidence for syntheses related to fathers and other family members, policy makers, and other health care providers and examination of issues related to emergency transfer to hospital, rural and remote home birth, and those who birth out of hospital, often at home, despite receiving antenatal care intended to increase healthcare-seeking behavior. Gaps in primary research suggest an examination is needed of perspectives in countries with higher maternal mortality and among first-time mothers and young mothers.Our scoping review identified a considerable body of research evidence on stakeholder perspectives of home birth. These could inform the complex factors influencing personal decisions and health system planning around home birth in both high- and low- and middle-resource countries. Future primary research is warranted on specific stakeholders worldwide and with vulnerable populations in areas of high maternal mortality.
家庭分娩在全球范围内的体验因人而异。这些体验可能因涉及的利益相关者类型（妇女、其支持人员、分娩助手、政策制定者）、体验本身（低风险分娩、转移到医院、以前的分娩）以及家庭分娩发生的卫生系统而异（例如，资源丰富与资源匮乏和中等资源国家）。关于利益相关者对家庭分娩的看法的研究证据，可以为个人和政策决策提供有用的信息，以选择和提供家庭分娩，但目前的文献分散且其广度尚不清楚。我们进行了系统的范围界定审查，以了解关于利益相关者对家庭分娩看法的研究文献在人群、背景和确定的问题方面的特点，以及研究证据中存在哪些潜在差距。我们搜索了一系列电子、基于网络的和关键信息源的证据。评估了定位的参考文献，使用可靠的方法提取和描述性分析数据。
我们的分析包括 460 份完整报告。来自高资源国家 210 项研究报告的结果表明，可以对父亲和同性伴侣、助产士和弱势群体以及自由分娩和转移到医院的观点进行研究。在家庭成员、政策制定者以及居住在农村和偏远地区的人群方面，主要研究存在差距。进一步的 250 份来自低资源和中等资源国家的研究报告表明，与父亲和其他家庭成员、政策制定者以及其他卫生保健提供者有关的证据，以及对与紧急转移到医院、农村和偏远地区家庭分娩以及那些尽管接受了旨在增加寻求医疗保健行为的产前护理，但仍在医院外分娩（通常是在家里）的问题进行检查的证据。主要研究中的差距表明，需要检查高孕产妇死亡率国家以及初产妇和年轻母亲的观点。
我们的范围界定审查确定了大量关于利益相关者对家庭分娩看法的研究证据。这些证据可以为个人决策以及高资源和低资源国家的家庭分娩卫生系统规划提供复杂因素的信息。有必要在全世界范围内对特定的利益相关者进行未来的初步研究，并对高孕产妇死亡率地区的弱势群体进行研究。
