The role, practice and training of unregulated birth-workers in Australia: a mixed methods study

Rigg, Elizabeth C. and Schmied, Virginia and Peters, Kath and Dahlen, Hannah G. (2017) The role, practice and training of unregulated birth-workers in Australia: a mixed methods study. In: ACM 2017 National Conference: Midwives: the Truth is Out There, 30 Oct 2017, Adelaide, Australia .

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Introduction: In Australia, the provision of homebirth services by unregulated birthworkers (UBW) (doulas, ex-registered midwives, traditional midwives and lay workers) appears to have increased in recent years. The reasons for this are unclear and no data exists to identify their numbers, training or work practices. Access to a homebirth with a registered midwife via mainstream services is limited and there is growing concern that new legislation aimed at prohibiting UBW practice may result in more women choosing to freebirth (birth at home with no professional support).

Aim: To explore the training, practices and role of Australian UBWs who assist women to give birth at home with no registered midwife present.

Methods: A mixed methods sequential exploratory design was used and had two phases. In phase 1, 9 participants, (4 UBWs and 5 women) were interviewed in in-depth individual interviews. Findings from Phase 1 informed the development of a National UBW survey in Phase 2. Ethics approval was gained from Western Sydney University Human Research Ethics committee No H10281.

Results: UBWs support women to have a normal physiological birth at home when they are unable to access a suitable homebirth from mainstream maternity services. They practice very like a registered midwife would providing antenatal, birth and postnatal care home without a midwife present. UBWs in this study were well educated and the majority held a midwifery (not currently registered or lay), nursing or allied health degree. All had completed further studies either in childbirth and/or complementary therapies to support their role. While UBWs do not call themselves a
midwife, women view them as their midwife.

Conclusion and implications: When women are unable to access homebirth support from registered maternity health care providers, they will seek support from UBWs. This has implications for the safety of mothers, their infants and UBWs in terms of legal ramifications in light of new Australian legislation which makes a UBW supported birth at home without a midwife illegal in some states. The findings of this study will inform discussions regarding improving mainstream maternity services delivery to ensure it is responsive to woman’s expressed needs and choices.

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Item Type: Conference or Workshop Item (Commonwealth Reporting Category E) (Speech)
Refereed: No
Item Status: Live Archive
Additional Information: Abstract only published, as supplied here.
Faculty / Department / School: Current - Faculty of Health, Engineering and Sciences - School of Nursing and Midwifery
Date Deposited: 25 Jan 2018 05:52
Last Modified: 21 Jun 2018 04:15
Uncontrolled Keywords: unregulated birth workers, freebirth, homebirth
Fields of Research : 11 Medical and Health Sciences > 1110 Nursing > 111006 Midwifery
Socio-Economic Objective: C Society > 92 Health > 9205 Specific Population Health (excl. Indigenous Health) > 920507 Women's Health
C Society > 92 Health > 9202 Health and Support Services > 920210 Nursing
Identification Number or DOI: 10.1016/j.wombi.2017.08.038

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