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Objective: To describe change in costs to different funders over time for women giving birth in Queensland between 2012 and 2018. Methods: A whole-of-population linked administrative dataset was used that contained all health service use in Queensland for women who gave birth between 1 July 2012 and 30 June 2018 and their babies. Aggregated costs for mother and baby from pregnancy to 12 months postpartum were used to compare the change in costs to funders over time. Results: There was an increase in mean total cost to all funders per birth in the public system and private system from 2012 to 2018. North West Hospital and Health Service (HHS) had the highest mean total cost (in Australian dollars) in 2018 (A$42 353), while home births had the lowest (A$6105). For the majority of HHSs the proportion of births with a positive birth outcome (as defined by a composite outcome measure) has remained largely static or declined during this time period. Cairns and Hinterland HHS and Townsville HHS had the largest declines of 15% and 16% respectively, while mean total cost to all funders rose 36.39% and 46.41%, respectively. Conclusions: There has been an increase over time across Queensland in the cost of childbirth in public hospitals and in the private system, while the cost of home birth has remained static. For most HHSs this increase in cost is also associated with little change or a decline in the percentage of births with a positive outcome. Increases in cost are therefore not being translated into better outcomes for women and their babies. Routine performance monitoring of cost, quality and safety should be adopted to ensure the provision of high value maternity care in Australia. What is known about the topic? Public maternity care costs vary in Australia dependent upon place of birth, even after adjusting for clinical and demographic factors. What does this paper add? This paper compares the change in costs for mother and baby from birth through to 12 months for births across Queensland over time. Costs for maternity care have increased over time and higher-cost treatment does not necessarily result in better health outcomes. What are the implications for practitioners? Reporting of cost alongside clinical outcomes should be included in performance monitoring of public hospital maternity care. [ABSTRACT FROM AUTHOR]

Background: Women's childbirth experiences in health facilities is at the core of quality of care. Their perceptions of poor-quality care, including disrespectful care at health facilities during childbirth, is recognized as a significant barrier to seeking care for subsequent births. Research that explores women's perspectives of the dimensions of disrespect and mistreatment during childbirth in Arab countries is scarce, and there is none pertaining to refugee groups who carry the burden of multiple vulnerabilities and who suffer from discontinued care, especially in fragile health systems. This paper aims at presenting Palestinian, Iraqi and Syrian refugee women's experiences, understanding and interpretation of disrespect and mistreatment during childbirth in hospitals in Lebanon.Methods: This study employed phenomenology, a qualitative research design to generate data through in-depth interviews. Women who were 3 to 6 months postpartum were recruited through the non-governmental organizations (NGOs) that are actively engaged in providing welfare and healthcare services to different populations of refugee women in Lebanon. In total, 24 women were interviewed. All interviews were audio recorded, transcribed verbatim and subjected to thematic analysis.Results: Of the 24 women who participated in this study, 9 were Palestinian, 12 were Syrian and 3 were Iraqi. The participants spoke of restricted choices to hospitals, care providers and to types of birth, while revealing adverse experiences during childbirth in healthcare facilities, including verbal and physical abuse, disrespectful verbal and non-verbal communication by healthcare providers. They also reported sub-standard care, denial of birth companions and breaches to their privacy. Our findings exemplify how the coverage of the cost of facility-based births by UN agencies and NGOs increase refugee women's vulnerability to disrespect and mistreatment during childbirth.Conclusion: This study shows how disrespect and mistreatment are intertwined in a complex system which is devised to ensure access to facility-based birth for displaced populations. Implications for programs and policies point to the need for strengthening capacity and for providing resources for the adaptation of global guidelines into context-specific strategies for the provision of quality maternity care during humanitarian crises and beyond. [ABSTRACT FROM AUTHOR]

Dr. Akira Ikegawa opened a maternity clinic in Japan and has been helping parents handle childbirth for 40 years. His interest in ensuring the healthy growth of children and a happy family life was stimulated while interacting with the people who visited his clinic. His research on prenatal memory resulted in a new parenting method designed to increase the happiness of parents and children. He discovered that parents must be conscious of receiving love from their children. In this paper, Ikegawa compares his experience with standard obstetrical practices in Japan and his experience after introducing the Prenatal Memory method in his clinic. He also provides thoughts on Prenatal Memory Education, which evolved from prenatal memory research from Japan. [ABSTRACT FROM AUTHOR]

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Background: Geographic barriers to healthcare are associated with adverse maternal health outcomes. Modelling travel times using georeferenced data is becoming common in quantifying physical access. Multiple Demographic and Health Surveys ask women about distance-related problems accessing healthcare, but responses have not been evaluated against modelled travel times. This cross-sectional study aims to compare reported and modelled distance by socio-demographic characteristics and evaluate their relationship with skilled birth attendance. Also, we assess the socio-demographic factors associated with self-reported distance problems in accessing healthcare.Methods: Distance problems and socio-demographic characteristics reported by 2210 women via the 2017 Ghana Maternal Health Survey were included in analysis. Geospatial methods were used to model travel time to the nearest health facility using roads, rivers, land cover, travel speeds, cluster locations and health facility locations. Logistic regressions were used to predict skilled birth attendance and self-reported distance problems.Results: Women reporting distance challenges accessing healthcare had significantly longer travel times to the nearest health facility. Poverty significantly increased the odds of reporting challenges with distance. In contrast, living in urban areas and being registered with health insurance reduced the odds of reporting distance challenges. Women with a skilled attendant at birth, four or more skilled antenatal appointments and timely skilled postnatal care had shorter travel times to the nearest health facility. Generally, less educated, poor, rural women registered with health insurance had longer travel times to their nearest health facility. After adjusting for socio-demographic characteristics, the following factors increased the odds of skilled birth attendance: wealth, health insurance, higher education, living in urban areas, and completing four or more antenatal care appointments.Conclusion: Studies relying on modelled travel times to nearest facility should recognise the differential impact of geographic access to healthcare on poor rural women. Physical access to maternal health care should be scaled up in rural areas and utilisation increased by improving livelihoods. [ABSTRACT FROM AUTHOR]

Introduction: Respectful maternity care (RMC) is fundamental to women's and families' experience of care and their decision about where to give birth. Studies from multiple countries describe the mistreatment of women during facility-based childbirth, though only a small number of studies from Guatemala have been published. Less information is available on women's negative and positive experiences of childbirth care and health workers' perceptions and experiences of providing maternity care.Methods: As part of a program implemented in the Western Highlands of Guatemala to improve quality of reproductive maternal newborn and child health care, a mixed methods assessment was conducted in three hospitals and surrounding areas to understand women's and health workers' experience and perceptions of maternity care. The quantitative component included a survey of 31 maternity health workers and 140 women who had recently given birth in these hospitals. The qualitative component included in-depth interviews (IDIs) and focus group discussions (FGDs) with women and maternity health workers and managers.Results: Women reported a mix of positive and negative experiences of childbirth care related to interpersonal and health system factors. 81% of surveyed women reported that health workers had treated them with respect while 21.4% of women reported verbal abuse. Fifty-five percent and 12% of women, respectively, reported not having access to a private toilet and bath or shower. During IDIs and FGDs, many women described higher rates of verbal abuse directed at women who do not speak Spanish. A regression analysis of survey results indicated that speaking Ixil or K'iche at home was associated with a higher likelihood of women being treated negatively during childbirth in a facility. Health worker survey results corroborated negative aspects of care described by women and also reported mistreatment of health workers by clients and families (70.9%) and colleagues (48.2%).Conclusions: This study adds to the literature on women's experience of institutional childbirth and factors that influence this experience by triangulating experience and perceptions of both women and health workers. This assessment highlights opportunities to address mistreatment of both women and health workers and to build on positive care attributes to strengthen RMC for all women. [ABSTRACT FROM AUTHOR]

Around 20% of births in Somaliland take place at health facilities staffed by trained healthcare professionals; 80% take place at home assisted by Traditional Birth Attendants (TBAs) with no formal training. There has been no research into women's choice of place of birth. In this study, we explore multipara women's needs and preferences when choosing the place of birth. An explorative qualitative study using individual in-depth interviews analysed inductively using content analysis. The interviews were conducted in Somaliland with 25 multiparous women who had experience of giving birth both at home and at a health facility within the past three years. The results provide a description of how, for women in Somaliland, a lack of reproductive agency in facility-based births makes home births a first choice regardless of potential risks and medical need. The women in this study desired intentionality in their role as mothers and sought some measure of control over the environment where they planned to give birth, depending on the circumstances of that particular birth. The results describe what quality care means for multipara women in Somaliland and how women choose birthplace based on previous experiences of care. The expectation of respectful care was a vital part for women when choosing a place of birth. To meet women's needs and preferences in Somaliland, further investments are needed to strengthen the midwifery profession and to define and test a context specific midwife-led continuity of care model to be scaled up. A dialogue to create new roles and responsibilities for the TBAs who attend most home births is further needed to link them to the formal healthcare system and assure timely healthcare seeking during pregnancy and birth. [ABSTRACT FROM AUTHOR]

aimed at reviewing identifying reasons for home delivery preference, determining the status of homebirth in Ethiopia, and identifying socio-demographic factors predicting home delivery in Ethiopia. Methods: A systematic literature review regarding the status of homebirth, reasons why women preferred homebirth and socio-demographic determinants of home deliveries was performed using CINAHL, MEDLINE, Google Scholar and Maternity and Infant Care. Keywords and phrases such as home birth, home delivery, childbirth, prevalence, determinants, predictors, women and Ethiopia were included in the search. Results: A total of 10 studies were included in this review. The mean proportion of homebirth was 73.5%. Maternal age, ANC visits, maternal level of education, distance to facilities, and previous facility birth were significantly associated with homebirth. Perceived poor quality of service, distant location of facilities, homebirth as customary in the society and perceived normalness of labour were identified as reasons for choosing homebirth. Conclusion: Despite the significance of skilled birth attendants in reducing maternal and newborn morbidity and mortality, unattended homebirth remains high. By identifying and addressing socio-demographic enablers of home deliveries, maternal health service uptake can be improved. [ABSTRACT FROM AUTHOR]

Background: Labour and childbirth mark another developmental phase in the life of a woman and her family. The processes that occur are physiological, social and psychological. Women anticipate labour differently hence, their different behaviour during labour. For some women the process of childbirth might result in increased feelings of insecurity, anxiety, and intense childbirth-related fear. The midwife as a key figure in this process should therefore, be supportive and assist the woman safely through childbirth by recognising and meeting her needs and wellbeing. The key concern for maternity care providers is that maternity care services continue to meet the needs and expectations of women and their families. Therefore understanding childbirth experiences and their meaning could be important in planning individualized care for mothers. The purpose of this study was to explore labour and childbirth experiences among primiparae in Monze district. Methods: The researcher used a qualitative design utilising the interpretive phenomenological approach to better understand the first time mothers' experiences of childbirth at Monze mission hospital. Twelve primiparae aged between 18 and 29 years within six weeks of giving birth were recruited to the study. A semi-structured interview was used to collect data, which was analysed using the thematic analysis method. Results: Two major themes that emerged from the data were: Support and care, and Childbirth reality. The major theme of support and care emerged from subthemes; comfort in the care received, delighted with availability of midwives and nurses, surprised with the care received, pain versus yelling by midwives, inadequate service provision, and labour pains. The results under support and care showed that the support and care received by women during childbirth were interpreted as being either positive or negative. The interpretations were generally centred on the attitudes, interpersonal communication, physical and psychological support, and management of labour complications by service providers. Physical and psychosocial support and care provided comfort, consolation and encouragement to the mothers, "...what I liked about this labour is how the nurse who delivered me spoke to me... The nurse said...today, I want to take care of you... she got a stool and sat near me (smile)...I felt very nice! Seeing the nurse sitting near me and saying, I just want to take care of you... I was very delighted because the midwife gave me full attention by sitting near me " Mrs MH narrated. While non-caring attitudes, poor communication and inappropriate care led to mothers' negative childbirth experiences "...there was no one who was there to talk with me. I don't know if they were too busy or there was shortage, but I was left alone and I didn 't like it... there was no care and support there!" Mrs CK said. The major theme of Childbirth reality for the first time mothers was interpreted in the sphere of childbirth related fears and the joy of seeing their new born babies. Experiencing labour for the first time was encompassed with fear of labour pains, midwives, labour ward, delivery, labour outcome, being operated, slow progress, and just fear of the unknown. All the study participants expressed joy at the birth of their babies and felt very happy when their babies were delivered. Some described it as a feeling of indescribable happiness that occurred when the baby slipped out and the pain suddenly disappeared. Conclusion: The childbirth phenomenon was experienced in a way that elicited unique exceptional feelings, responses and challenges that have potential to assist midwives provide and promote positive childbirth experiences for primigravidae. Satisfaction with childbirth was interpreted as the most important qualitative outcome in the assessment of the phenomenon because it was linked to postnatal emotional wellbeing, self-esteem and early interaction with the infant. Thus, understanding childbirth experiences and attached meanings is essential when planning intrapartum care for primigravidae. [ABSTRACT FROM AUTHOR]