Publicly-funded Homebirth in Victoria, Australia: Exploring the Views of Midwives and Doctors
Objective: To explore midwives’ and doctors’ views and experiences of publicly-funded homebirthing models. Design: Cross-sectional survey implemented two years after the introduction of publicly-funded homebirthing models. Setting: Two public hospitals in Victoria, Australia. Participants: Midwives and doctors (obstetric medical staff). Main outcome measures: Midwives’ and doctors’ views regarding reasons women choose homebirth; and views and experiences of a publicly-funded homebirth program, including intrapartum transfers. Findings: Of the 44% (74/167) of midwives who responded to the survey, the majority (86%) supported the introduction of a publicly-funded homebirth model, and most considered that there was consumer demand for the model (83%). Most thought the model was safe for women (77%) and babies (78%). These views were stronger amongst midwives who had experience working in the program (compared with those who had not). Of the 25% (12/48) of doctors who responded, views were mixed; just under half supported the introduction of a publicly-funded homebirth model, and one was unsure. Doctors also had mixed views about the safety of the model. One third agreed it was safe for women, one third were neutral and one third disagreed. Half did not believe the homebirth model was safe for babies. The majority of midwives (93%) and doctors (75%) believed that intrapartum transfers from home to hospital were easier when the homebirthing midwife was a member of the hospital staff (as is the case with these models). Key conclusions and implications for practice: Responding midwives were supportive of the introduction of publicly-funded homebirth, whereas doctors had divergent views and some were concerned about safety. To ensure the success of such programs it is critical that all key stakeholders are engaged at the development and implementation stages as well as in the ongoing governance. Highlights: • Midwives’ and doctors’ views of publicly-funded homebirth have not previously been investigated. • Midwives (in particular those who had experience working in the program) were very supportive of publicly-funded homebirth for women and most considered there was consumer demand for the model. Most believed the model was safe for women and babies. • Doctors had mixed views about publicly-funded homebirth. Some were supportive, some considered there to be consumer demand, and some considered it to be a safe model (others did not).