Homebirth in England: Factors that impact on job satisfaction for community midwives
This study explored the uptake of homebirth by healthy pregnant women from the perspective of community midwives (CMs). This paper presents factors that CMs expressed contributed to and/or detracted from their job satisfaction. Interviews were conducted with four practising CMs who were employed by a large acute NHS Trust in England providing a non-continuity model of care. Data were analysed thematically and are presented in two categories: (1) continuity of care and (2) working relationships and workloads. Findings suggest that if maternity service providers attended to factors that enhanced the job satisfaction of CMs inclined to support homebirth, this may contribute to increasing its uptake by pregnant women.
Homebirth rates in England have been persistently low for more than 5 decades, with just 2.3% of women giving birth at home in 2013 (Office for National Statistics, 2014). While homebirths currently represent a relatively small proportion of births in England, the National Institute for Health and Care Excellence (NICE) has published new national guidelines on intrapartum care that recommend healthy, low-risk pregnant women should be advised that birth at home or in a midwife-led unit is now particularly suitable for them (NICE, 2014). The recommendations are informed by research that has demonstrated that healthy women can give birth safely and cost-effectively if they choose a non-obstetric unit setting (Brockelhurst et al, 2011; Blix et al, 2012). This revised previous guidance (NICE, 2007) that urged caution, and has the potential to affect hundreds of thousands of births in England.
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