@ObMD @DrLSchummers @greenjrnl @NACPM @ACNMmidwives @BirthPlaceLab @wamidwives @ob_coap @Canadamidwives @TheUpliftLab 1/ Our study aim was NOT to compare ‘high-risk’ to ‘low-risk’ home birth.
Others have studied this: e.g. a w/ a US ITT cohort designed for place of birth research (Bovbjerg, 2017. Birth) and the UK Birthplace Study (Li, 2015. BJOG).
Others have studied this: e.g. a w/ a US ITT cohort designed for place of birth research (Bovbjerg, 2017. Birth) and the UK Birthplace Study (Li, 2015. BJOG).
2/ Saying “[high risk people] have no place in planned home births” in my mind, is akin to ‘telling people what to do with their bodies’ - and not useful in promoting safe, respectful maternity care.
3/ We can strongly and clearly recommend hospital birth with specific risks, but ‘telling women/birthing people what to do with their bodies’ is patriarchical - as is forced pregnancy.
4/ People choose home birth ‘outside of guidelines’, for many reasons. HCPs need well-designed research evidence (as from our study) to guide informed choice discussions with birthing people about planned place of birth.
5/ And, many hospitals could improve in providing respectful, individualized care. Not everyone feels 'safe' in the hospital. Lack of access to hospital-based VBAC is a known issue and can be a driver of planned home VBAC ncbi.nlm.nih.gov/pmc/articles/P…
6/ As ACOG acknowledges, birthing people and women have the “right to make a medically informed decision about delivery” – this includes planned place of birth. #birthautonomy
7/ Risk perception is a subjective response and combines both scientific information and life experiences, coping strategies, context of the event and the weight attached to the information obtained about the risk based on the individuals trust or distrust of the sources.
8/ “Some suggest that attending a woman who chooses to accept risk enables her choice. They hope that refusing to attend will force her to choose otherwise. This is a coercive and dangerous form of “chicken” that is ethically inappropriate in modern health care. ... "
9/ "Regardless of her choice, a woman and her fetus will face less risk with professional care than without it.” - Dr. Andrew Kotaska, 2018. Birth. onlinelibrary.wiley.com/doi/full/10.11…
10/ Please see excellent research on experiences and decision-making for people choosing home births with ‘risk factors’.
Occurs in Canada, the Netherlands, UK and US and is a fraction of all planned community births.
ncbi.nlm.nih.gov/pmc/articles/P…
pubmed.ncbi.nlm.nih.gov/27055760/
Occurs in Canada, the Netherlands, UK and US and is a fraction of all planned community births.
ncbi.nlm.nih.gov/pmc/articles/P…
pubmed.ncbi.nlm.nih.gov/27055760/
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