Factors influencing the use of birth pools in the United Kingdom: Perspectives of women, midwives and medical staff

Objective To identify factors influencing the use of birth pools. Design Online discussion groups and semi-structured interviews, analysed thematically. Setting United Kingdom. Participants 85 women and 21 midwives took part in online discussion groups; 14 medical staff participated in interviews. Findings Factors influencing the use of birth pools were grouped into three overarching categories: resources, unit culture and guidelines, and staff endorsement. Resources encompassed pool availability, efficiency of pool use and availability of waterproof cardiotocograph equipment. Unit culture and guidelines related to eligibility criteria for pool use, medicalisation of birth and differences between midwifery-led and obstetric-led care. Staff endorsement encompassed attitudes towards pool use. Key conclusions Accessibility of birth pools was often limited by eligibility criteria. While midwifery-led units were generally supportive of pool use, obstetric-led units were described as an over-medicalised environment in which pool use was restricted and relied on maternal request. Implications for practice Midwives can improve women's access to birth pools by providing information antenatally and proactively offering this as an option in labour. Maternity units should work to implement evidence-based guidelines on pool use, increase pool availability (even where there appears to be low demand), and enhance awareness amongst medical staff of the benefits of water immersion

Homelessness & Health in Canada

Homelessness & Health in Canada explores, for the first time, the social, structural, and environmental factors that shape the health of homeless persons in Canada. Covering a wide range of topics from youth homelessness to end-of-life care, the authors strive to outline policy and practice recommendations to respond to the ongoing public health crisis. This book is divided into three distinct but complimentary sections. In the first section, contributors explore how homelessness affects the health of particular homeless populations, focusing on the experiences of homeless youth, immigrants, refugees and people of Aboriginal ancestry. In the second section, contributors investigate how housing and public health policy as well as programmatic responses can address various health challenges, including severe mental illness and HIV/AIDS. In the final section, contributors highlight innovative Canadian interventions that have shown great promise in the field. Together, they form a comprehensive survey of an all too important topic and serve as a blueprint for action