1 Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, VBN2 Public Health and Epidemiology Group, The Faculty of Medicine, Aalborg University, VBN3 The Faculty of Medicine, Aalborg University, VBN4 unknown
issues of choice, access and equity
Title Planned place of birth: issues of choice, access and equity. Outline In Northern European countries, giving birth is generally safe for healthy women with uncomplicated pregnancies, and their babies. However, place of birth can affect women’s outcomes and experiences of birth. Whilst tertiary centres provide appropriate medical supervision to women with complex pregnancies, the likelihood of receiving interventions including surgical birth is increased for low risk women in these settings. In this symposium, we consider issues of choice, access and equitable care for women in the context of recent research on this topic. Individual papers/studies Stewart, M et al: The Birthplace in England Study – maternal outcomes and issues of choice and equity Overgaard, C et al: Freestanding midwifery units versus obstetric units – outcomes, care perceptions, equity and access in maternity care in Denmark Coxon K et al: Planned place of birth in England: perceptions of accessing obstetric units, midwife led units and home birth amongst women and their partners. How these papers interrelate These papers draw upon recent research in maternity care, undertaken in Denmark and in England. In both countries, maternity care is provided free to women, through public financing of health care; universal access to care is therefore secured. Nevertheless, different models of care exist, and debates about the appropriateness of providing maternity care in different settings take place in both countries, as in many other European nations. In this symposium, we seek to draw out some of the implications for women of opting for different settings for birth. Firstly, we compare evidence about rates of interventions in different birth settings. Secondly, we consider the extent to which transparent information about outcomes is provided to women in the course of their decision making. Finally, we explore the proposition that inequalities of access to different birth settings exist, and that these inequities impact upon women’s birth outcomes.