Women's Decision-Making And Factors Affecting Their Choice Of ...
Women's Decision-Making And Factors Affecting Their Choice Of ... Women's Decision-Making And Factors Affecting Their Choice Of ...
Chairmen of Local Medical Committees wanted home confinements to continue. They, however, stressed the need for women to choose whether they wanted to have their babies at home, and for proper assessments to be made to ensure the woman's home is safe. In paragraph 9, the report states that "the majority view was, therefore, that domiciliary midwifery should continue." states that: In its interpretations of the Medical Officers' views, the Peel Committee "...notwithstanding the majority of responding Chairmen recording views in favour, or acknowledging a need for continuance, of domiciliary midwifery, no extremity of view is prevalent. General practitioners are clearly aware that the indications, both medical and social, for home confinement need to be much more stringently assessed than those for a hospital confinement, in which risks are minimised" (para 145). There is no indication, from the summary of the chairmen's responses, that they considered hospital to have fewer risks than the home. On the contrary, the summary states: "Some [chairmen] expressed the view that the present trend towards hospital confinement is largely the result of a misleading pressure on the public, encouraging them to believe that hospital confinement is always better. They felt that this was not necessarily true" (para 5). It would appear from the chairmen's submissions that they were against the discontinuation of domiciliary midwifery. They felt that it was psychologically better for a woman to have her baby at home, that the birth of a child is a family matter, and should if possible take place in the shelter of the 15
home. They also put forward the fact that if the woman has other children at home, then it is better that she is not taken away from them for the period of confinement. Since the Chairmen of the Local Medical Committees did not express the view that hospital was safer than home, it could be argued that the Peel Committee were expressing their own views, possibly instilled by the recommendations of the Cranbrook committee, that hospital was safer than home. When the Peel committee reviewed maternity policy, the home birth rate was 12.4%. The committee considered hospital confinement safer than the home for the mother and baby, and therefore concluded that the situation justified the earlier recommendation by the Cranbrook report to provide sufficient facilities for an increasing number of women to have hospital confinements. They went on to recommend a 100% hospital delivery, thus phasing out home birth completely. The committee felt that even without specific policy direction, the institutional birth rate was showing every sign of going towards total hospital delivery, and therefore the discussion of the advantages and disadvantages of home or hospital birth was academic (para 248). The main argument for the recommendation of a universal hospital birth was the safety of mother and child. The conclusion that the hospital was safer than the home for delivery was reached without any supporting evidence. This assertion of safety in hospital became the focus of the debate on the place of birth, which is continuing up to now. There was no consideration for other factors that might influence women's preferences for home or hospital birth. 16
- Page 1 and 2: Women's Decision-Making And Factors
- Page 3 and 4: Figure 1: The paper elimination pro
- Page 5 and 6: Home themes with supporting quotati
- Page 7 and 8: Acknowledgements I would like to th
- Page 9 and 10: Kingdom is a pluralistic society, w
- Page 11 and 12: hospital delivery following a revie
- Page 13 and 14: The committee issued a press notice
- Page 15: The recommendations of the report u
- Page 19 and 20: equirements for the maximum lowerin
- Page 21 and 22: Previous committees had made their
- Page 23 and 24: The majority of those interviewed f
- Page 25 and 26: The Expert Maternity Group gathered
- Page 27 and 28: • The woman and, if she wishes, h
- Page 29 and 30: Chapter 2: Risk perception Chapter
- Page 31 and 32: From the health practitioner's pers
- Page 33 and 34: 1979), is a second approach to unde
- Page 35 and 36: normative factor. The individual's
- Page 37 and 38: and then choose the place they cons
- Page 39 and 40: example, they worried that the valu
- Page 41 and 42: they can easily imagine or recall a
- Page 43 and 44: are not necessarily chosen because
- Page 45 and 46: make decisions that are not necessa
- Page 47 and 48: Chapter 3: Systematic review of fac
- Page 49 and 50: considered. Primary research design
- Page 51 and 52: If the question of the review is no
- Page 53 and 54: Cochrane Database of Systematic rev
- Page 55 and 56: Table 2: Search terms used Search t
- Page 57 and 58: Table 3: Journals that were hand se
- Page 59 and 60: solely on the basis of the study re
- Page 61 and 62: they were recruited, at what stage
- Page 63 and 64: ,,, ... .g eD .E 0 o 4,7; (.5 g .5
- Page 65 and 66: -o -cs •b a) ..o ,:" .., -0 ti-,
home. They also put forward the fact that if the woman has other children at<br />
home, then it is better that she is not taken away from them for the period of<br />
confinement. Since the Chairmen of the Local Medical Committees did not<br />
express the view that hospital was safer than home, it could be argued that the<br />
Peel Committee were expressing their own views, possibly instilled by the<br />
recommendations of the Cranbrook committee, that hospital was safer than home.<br />
When the Peel committee reviewed maternity policy, the home birth rate<br />
was 12.4%. The committee considered hospital confinement safer than the home<br />
for the mother and baby, and therefore concluded that the situation justified the<br />
earlier recommendation by the Cranbrook report to provide sufficient facilities for<br />
an increasing number of women to have hospital confinements. They went on to<br />
recommend a 100% hospital delivery, thus phasing out home birth completely.<br />
The committee felt that even without specific policy direction, the institutional<br />
birth rate was showing every sign of going towards total hospital delivery, and<br />
therefore the discussion of the advantages and disadvantages of home or hospital<br />
birth was academic (para 248).<br />
The main argument for the recommendation of a universal hospital birth<br />
was the safety of mother and child. The conclusion that the hospital was safer<br />
than the home for delivery was reached without any supporting evidence. This<br />
assertion of safety in hospital became the focus of the debate on the place of birth,<br />
which is continuing up to now. There was no consideration for other factors that<br />
might influence women's preferences for home or hospital birth.<br />
16
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