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Improving Maternity Services: Small Is Beautiful—Lessons From A Birth Centre
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文摘
ethnography.

Setting

a birth centre situated in the midlands of England.

Participants

women attending the centre, midwives and maternity-care assistants (MCAs) working at the centre.

Findings

women in the study seemed to invoke intuitive nesting-related behaviours in their assessment of the suitability of the birth centre. In addition, the birth centre staff's focus on creating the right ambience for birth may also emanate from nesting concerns. Birth-centre staff assisted women through the ‘becoming mother’ transition, which is conceptualised as ‘matrescent’ care.

Key conclusions

the birth-centre environment elicited nesting-like behaviours from both women and staff. This formed part of a nurturing orientation that was conceptualised as ‘matrescent’ (becoming mother) care. ‘Matrescence’ does not seem to be grounded in clinical skills but is relationally mediated.

Implications for practice

nesting-like behaviours and ‘matrescent’ care in this context challenge maternity services to review traditional conceptualisations of safety and traditional expressions of clinical intrapartum care.


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Subverting the assembly-line: Childbirth in a free-stan...
Social Science & Medicine
Subverting the assembly-line: Childbirth in a free-standing birth centre
Social Science & Medicine, Volume 62, Issue 6, March 2006, Pages 1330-1340
Denis Walsh

Abstract
Across the world, concern is being expressed about the rising rates of birth interventions. As a result, there is growing interest in alternative organisational models of maternity care. Most of the research to date on these models has examined clinical outcomes. This paper, discussing key findings from an ethnographic study of a free-standing birth centre in the UK, explores organisational dimensions to care. It suggests that the advantages of scale have been under-recognised by policy makers to date. The birth centre displays organisational characteristics that contrast with the dominant Fordist/Taylorist model of large maternity units. These characteristics allow for greater temporal flexibility in labour care and tend to privilege relational, ‘being’ care over task-orientated, ‘doing’ care. In addition, features of a bureaucracy are much less in evidence, enabling entrepreneurial activity to flourish. There may be lessons here for other heath services as well as maternity services in optimising the advantages of small-scale provision.

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A retrospective cohort study comparing the clinical out...
Australian Midwifery
d49cd86cc23225b3d5"">A retrospective cohort study comparing the clinical outcomes of a birth centre and labour ward in the same hospital
Australian Midwifery, Volume 18, Issue 2, August 2005, Pages 17-21
Maureen Ryan, Christine Roberts

Abstract
To compare clinical outcomes of women attending a birth centre with similar women choosing labour ward birth, we conducted a retrospective cohort study. The 720 birth centre women were more likely to be older, more highly educated and of English-speaking-background than the 2963 labour ward women. Labour was more likely to commence spontaneously in the birth centre group and forceps and caesarean section births were also less likely to occur in this group. A greater proportion of infants of birth centre mothers had higher birth weights when categorised > 75th to 100th percentile. Any form of resuscitation was required less frequently in the birth centre group. Intervention rates in the birth centre were lower than those in the labour ward without any evidence of adverse infant outcomes.

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doi:10.1016/j.jmwh.2007.11.009
Copyright © 2008 American College of Nurse-Midwives Published by Elsevier Inc.

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Improving Maternity Services: Small Is Beautiful—Lessons From A Birth Centre

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