Place of birth is a contested and controversial topic worldwide. The World Health Organization (WHO, 1996) recommended that a woman should be able to give birth in the place of her choice where she feels safe, receives obstetrical care appropriate for her particular needs, and is located as close as possible to her home and culture. Missing from previous reviews on the topic of place and childbirth is an evaluation of environmental aspects or place characteristics that might contribute to experiential birth outcomes, synthesized from findings from both qualitative and quantitative methodologies. Evidence-based practice requires an understanding of birthplace in relation to birth experience that is more methodologically inclusive and theoretically informed.
The purpose of the proposed study was to synthesize empirical evidence regarding the relationship between place and the experiences of labor and childbirth. The guiding framework for this study was Therapeutic Landscapes. Mixed research synthesis methods were used to achieve the purpose of the proposed study.
Included in this synthesis were 77 English-language reports of empirical research conducted in 30 countries, published in peer-reviewed journals between January 2000 and September 2010, and available online through UNC libraries.
The findings from this research synthesis indicated that women across all geographic regions shared a common vision of a therapeutic landscape for birth. Women viewed or experienced those birth landscapes as therapeutic that were private, permitted freedom of movement and choice of delivery position, and accommodated family members and other support persons. Included within the landscape was a competent, confident and caring provider who was able to be with women throughout labor, regardless of where the birthplace was situated, and who did not impose what women saw as unnecessary interventions. Therapeutic landscapes for birth incorporated the active involvement of support persons. Therapeutic landscapes for birth provided women with a sense of safety. Women from all regions faced barriers to accessing therapeutic landscapes for birth. Women across regions chose the birthplace they believed would provide the most therapeutic landscape for birth, even if this meant avoiding hospitals and potentially life-saving resources.
|Commitee:||Crandell, Jamie L., Knafl, Kathleen A., Leeman, Jennifer, Lowe, Nancy K.|
|School:||The University of North Carolina at Chapel Hill|
|School Location:||United States -- North Carolina|
|Source:||DAI-B 73/09(E), Dissertation Abstracts International|
|Keywords:||Birth, Birthplaces, Childbirth, Labor, Midwives, Therapeutic landscapes|
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