Höfundar:
Kristín Hálfdánardóttir, Steinunn Blöndal, Berglind Hálfdánsdóttir
Introduction: Homebirth rate in Iceland has been around 2% for the last decade. Clinical guidelines, issued by the Directorate of Health, cite several contraindications for homebirth. Some contraindications occur in 8% of planned homebirths in Iceland. The research question of this study is: What affects whether a midwife chooses to attend to a woman who requests a homebirth with contraindications?
Methods: This was a qualitative study. Six midwives shared in in-depth interviews their experience when deciding whether to attend homebirths with contraindications. The interviews were analysed using the Vancouver-school of phenomenology.
Results: Comprehensive analysis was made of the phenomenon, based on the interviews. The structure is presented as a diagram of a bowl with the main theme: “Listen to the women”. This main theme emerges through all interviews as the midwives describe the importance of women being heard. On the bottom of the bowl two themes are seen as a base for the midwives’ decisions. They were: “Informed decision of the woman” and “Law and autonomy outweighs clinical guidelines”. The other six themes float around the bowl: “The woman’s background”, “Midwife-woman relationship”, “Midwife’s instinct”, “A difficult decision”, “Attitudes and views of other healthcare personnel” and “Safety first”.
Conclusion: The participating midwives can’t bear the thought of women having to birth unattended. They experience criticism, characterised by paternalism, from other healthcare workers when they attend homebirths with contraindications. The results of this study indicate that constructive and professional discussion, where all parties can speak and be listened to, should be recommended.