Work

Insights from a publicly funded homebirth program

Year: 2025

Type: article

Abstract: BACKGROUND: There are high levels of consumer demand for homebirth in Australia, however access is limited due to a wide range of factors, including associated costs of a private midwife and the limited number of publicly funded homebirth models. Homebirth with a qualified midwife, networked into a health system, is a safe option for women with a low-risk pregnancy. This paper has two aims. The first is to describe the implementation of a publicly funded homebirth service with an employed mentor. The second is to provide the outcomes from a matched cohort of women who received care from the same Midwifery Group Practice [MGP] who gave birth at home, compared with those who gave birth in hospital. METHODS: The retrospective comparative cohort study used routinely collected perinatal data from the hospital's electronic database (eMaternity) from July 2018 - October 2021. The cohort of interest were women who received care through MGP. They were identically matched by parity, age, Body Mass Index (BMI), spontaneous labour and gestation of 37-42 weeks. A description of the employed midwifery mentor to implement this model of care is also provided. FINDINGS: 100 women gave birth at home during the study period. They were more likely to have a physiological birth (p < 0.001), intact perineum (p < 0.0001), and less likely to have a postpartum haemorrhage (p < 0.0001) compared to the matched cohort of women who birthed in hospital. There were less assisted births and caesarean section births for women who transferred from home to hospital (p < 0.0001). No statistical differences were seen between groups for postpartum haemorrhage, and Apgar score of < 7 at 5 minutes. CONCLUSION: This study demonstrated favourable outcomes for women receiving MGP who planned to birth at home compared to those women who chose a hospital birth. This is consistent with the existing literature that place of birth makes a difference. A description of the role of a mentor in supporting the sustainability of a publicly funded homebirth program is provided. Further research is recommended to evaluate the mentor's role in implementing and sustaining the model.

Source: Women and Birth

DOI: 10.1016/j.wombi.2024.101864

Authors: Sheryl Sidery, Andrew Bisits, Virginia Spear, Allison Cummins

Institutions: Royal Hospital for Women, University of Newcastle Australia

Language: English

Topic: Maternal and Perinatal Health Interventions

Subfield: Obstetrics and Gynecology

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: hybrid

Estimated APC paid: $3,613