Berglind Halfdansdottir1, Olof A Olafsdottir2, Ingegerd Hildingsson3, Alexander Kr Smarason4, Herdis Sveinsdottir5. 1. Faculty of Nursing, School of Health Sciences, University of Iceland, Eirberg, Eiriksgata 34, 101 Reykjavik, Iceland. Electronic address: beh6@hi.is. 2. Faculty of Nursing, School of Health Sciences, University of Iceland, Eirberg, Eiriksgata 34, 101 Reykjavik, Iceland. Electronic address: olofol@hi.is. 3. Department of Nursing, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Solnavagen 1, 171 77 Stockholm, Sweden; Department of Women's and Children's Health, Uppsala University, Box 256, 751 05 Uppsala, Sweden. Electronic address: Ingegerd.Hildingsson@miun.se. 4. Institution of Health Science Research, University of Akureyri, Solborg v/Nordurslod, 600 Akureyri, Iceland. Electronic address: alexanders@fsa.is. 5. Faculty of Nursing, School of Health Sciences, University of Iceland, Eirberg, Eiriksgata 34, 101 Reykjavik, Iceland. Electronic address: herdis@hi.is.
Abstract
OBJECTIVE: to examine the relationship between attitudes towards home birth and birth outcomes, and whether women's attitudes towards birth and intervention affected this relationship. DESIGN: a prospective cohort study. SETTING: the study was set in Iceland, a sparsely populated island with harsh terrain, 325,000 inhabitants, high fertility and home birth rates, and less than 5000 births a year. PARTICIPANTS: a convenience sample of women who attended antenatal care in Icelandic health care centres, participated in the Childbirth and Health Study in 2009-2011, and expressed consistent attitudes towards home birth (n=809). FINDINGS: of the participants, 164 (20.3%) expressed positive attitudes towards choosing home birth and 645 (79.7%) expressed negative attitudes. Women who had a positive attitude towards home birth had significantly more positive attitudes towards birth and more negative attitudes towards intervention than did women who had a negative attitude towards home birth. Of the 340 self-reported low-risk women that answered questionnaires on birth outcomes, 78 (22.9%) had a positive attitude towards home birth and 262 (77.1%) had a negative attitude. Oxytocin augmentation (19.2% (n=15) versus 39.1% (n=100)), epidural analgesia (19.2% (n=15) versus 33.6% (n=88)), and neonatal intensive care unit admission rates (0.0% (n=0) versus 5.0% (n=13)) were significantly lower among women who had a positive attitude towards home birth. Women's attitudes towards birth and intervention affected the relationship between attitudes towards home birth and oxytocin augmentation or epidural analgesia. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the beneficial effect of planned home birth on maternal outcome in Iceland may depend to some extent on women's attitudes towards birth and intervention. Efforts to de-stigmatise out-of-hospital birth and de-medicalize women's attitudes towards birth might increase women׳s use of health-appropriate birth services.
OBJECTIVE: to examine the relationship between attitudes towards home birth and birth outcomes, and whether women's attitudes towards birth and intervention affected this relationship. DESIGN: a prospective cohort study. SETTING: the study was set in Iceland, a sparsely populated island with harsh terrain, 325,000 inhabitants, high fertility and home birth rates, and less than 5000 births a year. PARTICIPANTS: a convenience sample of women who attended antenatal care in Icelandic health care centres, participated in the Childbirth and Health Study in 2009-2011, and expressed consistent attitudes towards home birth (n=809). FINDINGS: of the participants, 164 (20.3%) expressed positive attitudes towards choosing home birth and 645 (79.7%) expressed negative attitudes. Women who had a positive attitude towards home birth had significantly more positive attitudes towards birth and more negative attitudes towards intervention than did women who had a negative attitude towards home birth. Of the 340 self-reported low-risk women that answered questionnaires on birth outcomes, 78 (22.9%) had a positive attitude towards home birth and 262 (77.1%) had a negative attitude. Oxytocin augmentation (19.2% (n=15) versus 39.1% (n=100)), epidural analgesia (19.2% (n=15) versus 33.6% (n=88)), and neonatal intensive care unit admission rates (0.0% (n=0) versus 5.0% (n=13)) were significantly lower among women who had a positive attitude towards home birth. Women's attitudes towards birth and intervention affected the relationship between attitudes towards home birth and oxytocin augmentation or epidural analgesia. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the beneficial effect of planned home birth on maternal outcome in Iceland may depend to some extent on women's attitudes towards birth and intervention. Efforts to de-stigmatise out-of-hospital birth and de-medicalize women's attitudes towards birth might increase women׳s use of health-appropriate birth services.
Authors: Marta Campiotti; Rita Campi; Michele Zanetti; Paola Olivieri; Alice Faggianelli; Maurizio Bonati Journal: Int J Environ Res Public Health Date: 2020-04-15 Impact factor: 3.390