Relationships are the key to a successful publicly funded homebirth program, a qualitative study

Abstract

BackgroundIn Australia, publicly-funded homebirth is a relatively new option for women and their families. Two years after the inception of two publicly funded homebirth services in Victoria in 2009, a study found that midwives’ experiences were more positive than doctors. There is no recent evidence on the perspectives of midwives and doctors of publicly-funded homebirth programs. AimTo explore the experiences of midwives and doctors participating in or supporting one publicly-funded homebirth program in Australia. MethodsAn interpretive descriptive approach was used following individual in-depth interviews via ‘Zoom’. Participants included midwives and doctors who provide or support the homebirth service at a large metropolitan health service in Melbourne’s western suburbs. Data were thematically analysed. FindingsInterviews were conducted with 16 homebirth midwives, six hospital-based midwives, and nine doctors. One central theme and three sub-themes demonstrate that effective relationships are critical to a successful publicly-funded homebirth program. Collaboration, teamwork, and mutual respect across professions were reported to be integral to success. The midwife-woman relationship was highly valued and especially important to provide continuity during transfers to the hospital where this occurred. DiscussionEffective relationships underpin collaborative practice and are critical for safe healthcare. Shared common learning opportunities such as simulation training sessions and multi-professional forums to discuss cases were perceived to assist the development of these relationships. ConclusionEffective relationships within and between midwives and doctors are key to collaborative practice, which underpins a successful publicly-funded homebirth service. Health services can support this by maintaining a respectful and supportive culture amongst staff.