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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2015

Open Access 01-12-2015 | Research article

Women’s experiences of transfer from primary maternity unit to tertiary hospital in New Zealand: part of the prospective cohort Evaluating Maternity Units study

Authors: Celia P. Grigg, Sally K. Tracy, Virginia Schmied, Amy Monk, Mark B. Tracy

Published in: BMC Pregnancy and Childbirth | Issue 1/2015

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Abstract

Background

There is worldwide debate regarding the appropriateness and safety of different birthplaces for well women. The Evaluating Maternity Units (EMU) study’s primary objective was to compare clinical outcomes for well women intending to give birth in either a tertiary level maternity hospital or a freestanding primary level maternity unit. Little is known about how women experience having to change their birthplace plans during the antenatal period or before admission to a primary unit, or transfer following admission. This paper describes and explores women’s experience of these changes-a secondary aim of the EMU study.

Methods

This paper utilised the six week postpartum survey data, from the 174 women from the primary unit cohort affected by birthplace plan change or transfer (response rate 73 %). Data were analysed using descriptive statistics and thematic analysis. The study was undertaken in Christchurch, New Zealand, which has an obstetric-led tertiary maternity hospital and four freestanding midwife-led primary maternity units (2010–2012). The 702 study participants were well, pregnant women booked to give birth in one of these facilities, all of whom received continuity of midwifery care, regardless of their intended or actual birthplace.

Results

Of the women who had to change their planned place of birth or transfer the greatest proportion of women rated themselves on a Likert scale as unbothered by the move (38.6 %); 8.8 % were ‘very unhappy’ and 7.6 % ‘very happy’ (quantitative analysis). Four themes were identified, using thematic analysis, from the open ended survey responses of those who experienced transfer: ‘not to plan’, control, communication and ‘my midwife’. An interplay between the themes created a cumulatively positive or negative effect on their experience. Women’s experience of transfer in labour was generally positive, and none expressed stress or trauma with transfer.

Conclusions

The women knew of the potential for change or transfer, although it was not wanted or planned. When they maintained a sense control, experienced effective communication with caregivers, and support and information from their midwife, the transfer did not appear to be experienced negatively. The model of continuity of midwifery care in New Zealand appeared to mitigate the negative aspects of women’s experience of transfer and facilitate positive birth experiences.
Literature
1.
Grigg C, Tracy S, Daellenbach R, Kensington M, Schmied V. An exploration of influences on women’s birthplace decision-making in New Zealand: a mixed methods prospective cohort within the Evaluating Maternity Units study. BMC Pregnancy Childbirth. 2014;14(210):14.
2.
Rowe R, Kurinczuk J, Locock L, Fitzpatrick R. Women’s experience of transfer from midwifery unit to hospital obstetric unit during labour: a qualitative interview study. BMC Pregnancy Childbirth. 2012;12(129):15.
3.
Walker J. Women’s experiences of transfer from midwife-led to consultant-led maternity unit in the UK during late pregnancy and labor. J Midwifery Womens Health. 2000;45(2):161–8.PubMedCrossRef
4.
Creasy J. Women’s experience of transfer from community-based to consultant-based maternity care. Midwifery. 1997;13:8.CrossRef
5.
Overgaard C, Fenger-Gron M, J S. The impact of birthplace on women’s birth experiences and perceptions of care. Soc Sci Med. 2012;74:973–81.PubMedCrossRef
6.
Patterson J, Foureur M, Skinner J. Patterns of transfer in labour and birth in rural New Zealand. Rural Remote Health. 2011;11(1710):15.
7.
Geerts C, Klomp T, Lagro-Janssen A, Twisk J, van Dillen J, de Jonge A. Birth setting and maternal sense of control: results from the DELIVER study. BMC Pregnancy Childbirth. 2014;14(27):1–11.
8.
Christiaens W, Gouwy A, Bracke P. Does referral from home to hospital affect satisfaction with childbirth? A cross-national comparison. BMC Health Serv Res. 2007;7(109):1–9.
9.
Wiegers T, van der Zee J, Keirse M. Transfer from home to hospital: what is its effect on the experience of childbirth? Birth. 1998;25(1):19–24.PubMedCrossRef
10.
11.
Fox D, Sheehan A, Homer C. Experiences of women planning a home birth who require intrapartum transfer to hospital: a metasynthesis of qualitative literature. Int Child-Comput Childbirth. 2014;4(2):103–19.CrossRef
12.
de Jonge A, Stuijt R, Eijke I, Westerman M. Continuity of care: what matters to women when they are referred from primary to secondary care during labour? a qualitative interview study in the Netherlands. BMC Pregnancy Childbirth. 2014;14(103):1–11.
13.
Dahlen H, Barclay L, Homer C. The novice birthing: theorising first time mothers’ experiences of birth at home and in hospital in Australia. Midwifery. 2010;26(1):53–63.PubMedCrossRef
14.
Hauck Y, Fenwick J, Downie J, Butt J. The influence of childbirth expectations on Western Australian women’s perceptions of their birth experience. Midwifery. 2007;23:235–47.PubMedCrossRef
15.
Larkin P, Begley C, Devane D. Women’s experiences of labour and birth: an evolutionary concept analysis. Midwifery. 2009;25:e49–59.PubMedCrossRef
16.
Larkin P, Begley C, Devane D. ‘Not enough people to look after you’: an exploration of women’s experiences of childbirth in the Republic of Ireland. Midwifery. 2012;28:98–105.PubMedCrossRef
17.
Leap N, J S, Buckland S. Journey to confidence: women’s expeirences of pain in labour and relational continuity of care. J Midwifery Women’s Health. 2010;55(3).
18.
19.
Donley J. Birthrites, Natural vs unnatural childbirth in New Zealand. Auckland, New Zealand: The Full Court Press; 1998.
20.
21.
22.
Skinner J, Foureur M. Consultation, referral, and collaboration between midwives and obstetricians: Lessons from New Zealand. J Midwifery Women’s Health. 2010;55(1):28–37.CrossRef
23.
24.
Monk A, Tracy M, Foureur M, Grigg C, Tracy S. Evaluating Midwifery Units (EMU): a prospective cohort study of freestanding midwifery units in New South Wales, Australia. BMJ Open. 2014;4(e006252):1–11.
25.
Grigg C, Tracy S, Schmied V, Daellenbach R, Kensington M. Women’s birthplace decision-making, the role of confidence: part of the Evaluating Maternity Units study, New Zealand. Midwifery. 2015;31:597–605.PubMedCrossRef
26.
Grigg C, Tracy S, Tracy M, Schmied V, Monk A: Transfer from primary maternity unit to tertiary hospital in New Zealand-timing, frequency, reasons, urgency and outcomes: part of the Evaluating Maternity Units study. Midwifery 2015, 31:879-887.
27.
Denscombe M. Communities of practice, a research paradigm for the mixed methods approach. J Mixed Methods Res. 2008;2(3):270–83.CrossRef
28.
Johnson RB, Onwuegbuzie A. Mixed methods research: A research paradigm whose time has come. Educ Res. 2004;33(7):14–26.CrossRef
29.
Morgan D. Paradigms lost and pragmatism regained, methodological implications of combining qualitative and quantitative methods. J Mixed Methods Res. 2007;1(1):48–76.CrossRef
30.
Leech N, Onwuegbuzie A. A typology of mixed method research designs. Qual Quant. 2009;43:265–75.CrossRef
31.
Teddlie C, Tashakkori A. A general typology of research designs featuring mixed methods. Res Schools. 2006;13(1):12–28.
32.
33.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–107.CrossRef
34.
Gibson W, Brown A. Working with qualitative data. London: Sage publications Ltd; 2009.
35.
Dove S, Muir-Cochrane E. Being safe practitioners and safe mothers: a critical ethnography of continuity of care midwifery in Australia. Midwifery. 2014;30:1063–72.PubMedCrossRef
36.
Gamble J, Creedy D, Teakle B. Women’s expectations of maternity services: a community-based survey. Women Birth. 2007;20:115–20.PubMedCrossRef
37.
Halldorsdottir S, Karlsdottir S. Journeying through labour and delivery: perceptions of women who have given birth. Midwifery. 1996;12:48–61.PubMedCrossRef
38.
39.
Lavender T, Walkinshaw S, Walton I. A prospective study of women’s views of factors contributing to a positive birth experience. Midwifery. 1999;15:40–6.PubMedCrossRef
40.
Howarth A, Swain N, Treharne G. First-time New Zealand mothers’ experience of birth: importance of relationship and support. New Zealand College of Midwives Journal. 2011;45:6–11.
41.
Hunter B, Berg M, Lundgren I, Olafsdottir O, Kirkham M. Relationships: the hidden threads in the tapestry of maternity care. Midwifery. 2008;24:132–7.PubMedCrossRef
42.
Williams K, Lago L, Lainchbury A, Eagar K. Mothers’ views of caseload midwifery and the value of continuity of care at an Australian regional hospital. Midwifery. 2010;26:615–21.PubMedCrossRef
43.
Hodnett E. Pain and women’s satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol. 2002;186:S160–72.PubMed
44.
Ford E, Ayers S. Stressful events and support during birth: the effect on anxiety, mood and perceived control. J Anxiety Disorders. 2009;23:260–8.CrossRef
45.
Newick L, Vares T, Dixon L, Johnston J, Guilliland K. A midwife who knows me: women tertiary students’ perceptions of midwifery. New Zealand College of Midwives Journal. 2013;47:5–9.
46.
Guilliland K, Pairman S. The midwifery Partnership: a model for practice. Wellington: Victoria University of Wellington, Department of Nursing and Midwifery, Monograph Series 95/1; 1995.
47.
New Zealand College of Midwives. Midwives handbook for practice (includes Standards of Midwifery Practice and a Code of Ethics), Midwifery Standards Review handbook, and Consensus statements. Christchurch: New Zealand College of Midwives; 2011.
48.
Davis D, Walker K. Case-loading midwifery in New Zealand: bridging the normal/abnormal divide ‘with women’. Midwifery. 2011;27:46–52.CrossRef
Metadata
Title
Women’s experiences of transfer from primary maternity unit to tertiary hospital in New Zealand: part of the prospective cohort Evaluating Maternity Units study
Authors
Celia P. Grigg
Sally K. Tracy
Virginia Schmied
Amy Monk
Mark B. Tracy
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2015
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-015-0770-2

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