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 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.
['Holten|Lianne|L|', 'Hollander|Martine|M|', 'de Miranda|Esteriek|E|']
D000328:Adult D001291:Attitude of Health Personnel D003220:Conflict, Psychological D054626:Consumer Health Information D005260:Female D066296:Grounded Theory D007722:Health Knowledge, Attitudes, Practice D006700:Home Childbirth D006801:Humans D008880:Midwifery D009426:Netherlands D026706:Paternalism D010465:Perception D011247:Pregnancy D018566:Pregnancy, High-Risk D036301:Qualitative Research D012307:Risk Factors D012959:Socioeconomic Factors D018454:Spouses D035502:Trust
multiple case study home birth the Netherlands trauma shared decision making DESCARTE model high risk negotiation phenomenological qualitative