Knox-Kazimierczuk Francoise, Trinh Shannon, Odems Dorian, Shockley-Smith Meredith
Department of Rehabilitation, Exercise, & Nutrition Science University of Cincinnati Cincinnati Ohio USA.
Department of Population Health College of Health & Human Services, The University of Toledo Toledo Ohio USA.
Health Sci Rep. 2023 Jul 20;6(7):e1387. doi: 10.1002/hsr2.1387. eCollection 2023 Jul.
The impact of the COVID-19 pandemic on the healthcare system facilitated a change in policies to redress the consequences of increased demand and fear of disease transmission. Restrictive measures throughout the healthcare system limiting access to accompanying partners of birthing people in addition to fears of contracting COVID-19, an increasing number of birthing people chose to have an out-of-hospital birth. Out-of-hospital births are not prevalent in the United States. However, in recent years the percentage of out-of-hospital births has been steadily increasing. COVID-19 was a novel virus imposing a unique birthing situation for millions of women, complicated by lack of integration and varied policies in the U.S.
To better understand the challenges of birthing people during the pandemic a scoping review was conducted to explore the literature during the first wave of the pandemic related to out-of-hospital births. The approach for this review made use of the methodology manual published by the Joanna Briggs Institute for scoping reviews. All manner of publications (i.e. peer-reviewed published articles, grey articles, conference proceedings, webinars, editorials, and textbook chapters) were included in the review.
Articles retrieved from the database search yielded sixty-three articles, after duplicate removal forty-six records were available for screening. Articles were further excluded using the PRISMA process, yielding thirty-one remaining records. From the thirty-one records twelve themes emerged, which were collapsed into four meta-themes.
These meta-themes focused on (a) advocacy, (b) homebirth infrastructure, (c) support networks, and (d) uncertainty during the pandemic. COVID-19 has accelerated this movement to birthing at home and thought must be given to how the healthcare system is going to support and integrate this mode of birthing.
新冠疫情对医疗系统的影响促使政策发生变化，以应对需求增加和对疾病传播的恐惧所带来的后果。整个医疗系统的限制措施限制了分娩者的陪伴伙伴入院，再加上对感染新冠病毒的恐惧，越来越多的分娩者选择在家分娩。在家分娩在美国并不普遍。然而，近年来在家分娩的比例一直在稳步上升。新冠病毒是一种新型病毒，给数百万女性带来了独特的分娩情况，美国缺乏整合且政策各异，使情况更加复杂。
为了更好地了解疫情期间分娩者面临的挑战，我们进行了一项范围综述，以探索疫情第一波期间与在家分娩相关的文献。本次综述采用了乔安娜·布里格斯循证卫生保健中心范围综述方法手册中公布的方法。综述纳入了所有类型的出版物（即同行评审的发表文章、灰色文献、会议论文集、网络研讨会、社论和教科书章节）。
从数据库搜索中检索到的文章有63篇，去除重复后有46条记录可供筛选。使用PRISMA流程进一步排除文章，最终剩下31条记录。从这31条记录中提炼出12个主题，这些主题被归纳为4个元主题。
这些元主题聚焦于（a）宣传，（b）家庭分娩基础设施，（c）支持网络，以及（d）疫情期间的不确定性。新冠疫情加速了在家分娩的趋势，必须思考医疗系统将如何支持和整合这种分娩方式。
