When the Hospital Is No Longer an Option: A Multiple Case Study of Defining Moments for Women Choosing Home Birth in High-Risk Pregnancies in The Netherlands

Some women in a high-risk pregnancy go against medical advice and choose to birth at home with a “holistic” midwife. In this exploratory multiple case study, grounded theory and triangulation were employed to examine 10 cases. The women, their partners, and (regular and holistic) health care profess...

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Bibliographic Details
Published in:Qualitative health research 2018-10, Vol.28 (12), p.1883-1896
Main Authors: Holten, Lianne, Hollander, Martine, de Miranda, Esteriek
Format: Article
Language:English
Subjects:
Childbirth & labor
Clinical decision making
Continuity of care
Grounded theory
Group decision making
Health technology assessment
High risk
Holistic approach
Home births
Medical personnel
Midwives
Paternalism
Pregnancy
Pregnancy complications
Qualitative research
Triangulation
Womens health
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Summary:Some women in a high-risk pregnancy go against medical advice and choose to birth at home with a “holistic” midwife. In this exploratory multiple case study, grounded theory and triangulation were employed to examine 10 cases. The women, their partners, and (regular and holistic) health care professionals were interviewed in an attempt to determine whether there was a pattern to their experiences. Two propositions emerged. The dominant one was a trajectory of trauma, self-education, concern about paternalism, and conflict leading to a negative choice for holistic care. The rival proposition was a path of trust and positive choice for holistic care without conflict. We discuss these two propositions and make suggestions for professionals for building a trusting relationship using continuity of care, true shared decision making, and an alternative risk discourse to achieve the goal of making women perceive the hospital as safe again.
ISSN:1049-7323
1552-7557
DOI:10.1177/1049732318791535