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The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.
This title is directed primarily towards health care professionals outside of the United States. This book explores the complex interrelationship between risk and choice in maternity care, taking a close look at how "high" and "low" risk are defined and what impact this has on a woman's ability to exercise informed choices throughout pregnancy. It offers an international collaboration that highlights different perspectives on debated issues, with chapters on maternity care in the UK, United States, Australia, and Ireland contributed by midwives, obstetricians, risk management experts, and sociologists. The aim of this book is to illustrate the changing reality of risk management as it relates to maternity care, and to highlight risk management concerns that may limit the choices available to pregnant women. Clarifies how applications of risk affect the choices pregnant women are able to exercise. Locates pregnancy risk considerations within the overall scheme of risk management. Analyzes practitioners' responses to the requirements of risk management. Presents risk management and choice from the risk manager's perspective, providing an understanding of risk as a "macro concept" in health care. Highlights medico-legal opinions on exercising choice, underscoring the need for accurate information and the ability to make informed decisions. Two chapters examine women's perspectives on risk labeling and the impact this has on choice - one in which the concept of safety within maternity care is discussed, and one in which the views of women with defined risk factors are explored and their ability to make choices is evaluated. Two chapters written by health service risk managers discuss the differences between an inner-city approach and a rural approach to the debate surrounding risk and choice. Discusses midwifery's focus on "normality" in childbirth and considers how this viewpoint affects the risk dialogue, including a chapter on clinical trends in maternity care. An obstetric perspective on risk refutes criticisms of obstetricians as being more likely to impose risk labels and limit choices by discussing how risks and choices are presented and considered within obstetric care. Explores the debate surrounding a woman's right to have a home birth in Ireland, in light of its risk management climate. Two chapters discuss the collaboration between service users, midwives, and obstetricians in Australia regarding the organization and delivery of maternity care, as well as the views concerning risk among indigenous Australians. Perspectives from nurse-midwives in the U.S. discuss the complex relationships among nurse-midwives, obstetricians, and pregnant women with regard to choice, including views on risk within immigrant communities.
Endorsed by the Australian College of Midwives and The Royal College of Midwives Midwifery Continuity of Care is a robust 'how to' guide to establishing midwifery continuity of care. Written by a team of international experts in their field, this book highlights lessons learned to help develop new ways of planning, implementing, evaluating and sustaining midwifery continuity of care for the benefit of women, babies and communities. - Summarises the evidence for midwifery continuity of care to support policy makers, commissioners of maternity services and health service executives with their implementation of midwifery continuity of care - Practical real world examples, stories and experiences to bring to life the diversity of ways that midwifery continuity of care can be implemented - Highlights a range of issues for managers and leaders to be aware of, including organisational, industrial and safety and quality issues - Explores how building alliances can enable midwifery continuity of care to flourish, addressing scaling up and sustainability Evolve Student and Faculty Resources: - eBook on VitalSource - An inspirational video interview with author, Jane Sandall
Optimizing outcomes for women in labor at the global level requires evidence-based guidance of health workers to improve care through appropriate patient selection and use of effective interventions. In this regard, the World Health Organization (WHO) published recommendations for induction of labor in 2011. The goal of the present guideline is to consolidate the guidance for effective interventions that are needed to reduce the global burden of prolonged labor and its consequences. The primary target audience includes health professionals responsible for developing national and local health protocols and policies, as well as obstetricians, midwives, nurses, general medical practitioners, managers of maternal and child health programs, and public health policy-makers in all settings.
This book investigates why women choose ‘birth outside the system’ and makes connections between women’s right to choose where they birth and violations of human rights within maternity care systems. Choosing to birth at home can force women out of mainstream maternity care, despite research supporting the safety of this option for low-risk women attended by midwives. When homebirth is not supported as a birthplace option, women will defy mainstream medical advice, and if a midwife is not available, choose either an unregulated careprovider or birth without assistance. This book examines the circumstances and drivers behind why women nevertheless choose homebirth by bringing legal and ethical perspectives together with the latest research on high-risk homebirth (breech and twin births), freebirth, birth with unregulated careproviders and the oppression of midwives who support unorthodox choices. Stories from women who have pursued alternatives in Australia, Europe, Russia, the UK, the US, Canada, the Middle East and India are woven through the research. Insight and practical strategies are shared by doctors, midwives, lawyers, anthropologists, sociologists and psychologists on how to manage the tension between professional obligations and women’s right to bodily autonomy. This book, the first of its kind, is an important contribution to considerations of place of birth and human rights in childbirth.
This guide provides a full range of updated, evidence-based norms and standards that will enable health care providers to give high quality care during pregnancy, delivery and in the postpartum period, considering the needs of the mother and her newborn baby. All recommendations are for skilled attendants working at the primary level of health care, either at the facility or in the community. They apply to all women attending antenatal care, in delivery, postpartum or post abortion care, or who come for emergency care, and to all newborns at birth and during the first week of life (or later) for routine and emergency care. This guide is a guide for clinical decision-making. It facilitates the collection; analysis, classification and use of relevant information by suggesting key questions, essential observations and/or examinations, and recommending appropriate research-based interventions. It promotes the early detection of complications and the initiation of early and appropriate treatment, including time referral, if necessary. Correct use of this guide should help reduce high maternal and perinatal mortality and morbidity rates prevalent in many parts of the developing world, thereby making pregnancy and childbirth safer.
Health Insurance is a Family Matter is the third of a series of six reports on the problems of uninsurance in the United Sates and addresses the impact on the family of not having health insurance. The book demonstrates that having one or more uninsured members in a family can have adverse consequences for everyone in the household and that the financial, physical, and emotional well-being of all members of a family may be adversely affected if any family member lacks coverage. It concludes with the finding that uninsured children have worse access to and use fewer health care services than children with insurance, including important preventive services that can have beneficial long-term effects.
"Evidence-based maternity care uses the best available research on the safety and effectiveness of specific practices to help guide maternity care decisions and to facilitate optimal outcomes in mothers and newborns."-- From foreword.
Fully up to date, this new edition covers all aspects of care for women developing disorders during pregnancy.
The rhetoric of choice is much used in UK health policy and home birth is one of the three options that women are entitled to choose between when deciding where to have their baby. However, many women making this choice run into considerable opposition from the maternity service. Home Birth: the politics of difficult choices focuses on the experiences of women whose choices were opposed by health professionals during their pregnancy journey. It confronts why and how women are being denied home birth and raises some challenging issues for current midwifery practice. Using ten women’s narratives, this important volume explores why women might want to give birth at home and considers ideas of risk and informed choice in pregnancy and birth. The book includes chapters on communication and language; fear and stress; advocacy and autonomy; fathers’ experience of contested place of birth and free birthing. Pointers to best practice are presented whilst the text incorporates women’s narratives throughout, making this a practical and relevant read for midwifery students as well as practising midwives and childbirth educators, all of whom have a duty to make home birth a real option for women.