Baddock, Sally

Benn, Cheryl

Davis, Deborah

Dixon, Lesley

Herbison, Peter

Hunter, Marion

Pairman, Sally

Wilson, D

Purpose: Midwives practising as lead maternitycaregivers in New Zealand (NZ) providecontinuity of care to women who choose to givebirth in a variety of settings including home,primary maternity units, secondary and tertiarylevel hospitals. The purpose of this study was tocompare how frequently the planned place of birthmatched the actual place of birth for a cohort oflow risk women in the care of midwives and toidentify whether ethnicity influences women’schoices in relation to planned place of birth.Method: The Midwifery and MaternityProvider Organisation (MMPO) database wasaccessed with agreement from the NZ Collegeof Midwives (NZCOM). Ethical approvalwas gained from the NZ Multi-region EthicsCommittee. Data were obtained from theMMPO database from 2006-2007 for a totalof 39,667 births. Data were reduced throughexclusion criteria to establish the cohort of16,453 low risk women (41.47% of totalsample) according to planned birthplace. TheStata statistical package was used to analyse datafor this cohort of low risk women.Results: Within the total cohort (n=16,453),9.36% of women had a homebirth, 16.25%of women birthed in a primary maternity unitand 74.36% of women birthed in a secondary/tertiary hospital. Five women (0.03%) birthedin an atypical small maternity unit withaccess to epidural analgesia. This facility wascategorised as a ‘primary plus’ facility and isdifferent from primary units and secondary/tertiary hospitals. Of the women planninga homebirth, 82.68% (n =1,513) gave birthat home. Just over ninety percent (n= 2,594)of women planning to birth in a primarymaternity unit gave birth in this settingand over 99% of women planning birth insecondary/tertiary hospitals (n = 12,066) gavebirth there. Only 3.95% of multiparous womendid not give birth in their planned birthplaceas compared with 6.02% of primiparouswomen. This result was statistically significant(panalysed by ethnicity and by the percentage ofeach ethnicity that planned to birth at home,primary, and secondary/tertiary settings.Twenty three percent of Māori women choseto birth in a primary maternity unit comparedwith 18% of NZ European, 14% Pacifica and10% of Asian women. Thirteen percent of NZEuropean women planned homebirth comparedwith 9% of Māori, 7% Pacifica and 4% of Asianwomen. There was no statistically significantdifference between ethnic groups and theirplanned and actual birthplace.Conclusion: There is a high association betweenintended and actual birthplace in relation tohomebirth and primary maternity units; parouswomen were significantly more likely to give birthin their planned birthplace. While only a quarterof this low risk cohort chose to give birth in thelow technology settings of home or a primarymaternity unit, this study shows that women whoplanned to birth in such settings, generally did so.Māori women were the ethnic group most likely tochoose a primary maternity unit as their plannedbirthplace. It is important that low risk womencontinue to be able to choose their place of birthand that primary maternity units are availableto them. This may be particularly important forindigenous NZ women

Anderson, Jacqui

University of Canberra Research Repository

Do low risk women actually birth in their planned place of birth and does ethnicity influence women's choices of birthplace?

Do low risk women actually birth in their planned place of birth and does ethnicity influence women's choices of birthplace?

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University of Canberra Research Repository