title: Publicly-funded home birth in Victoria, Australia: Exploring the views and experiences of midwives and doctors.
abstract: OBJECTIVE
  to explore midwives' and doctors' views and experiences of publicly-funded homebirthing models.
  
  
  METHODS
  cross-sectional survey implemented two years after the introduction of publicly-funded homebirthing models.
  
  
  METHODS
  two public hospitals in Victoria, Australia.
  
  
  METHODS
  midwives and doctors (obstetric medical staff).
  
  
  METHODS
  midwives' and doctors' views regarding reasons women choose home birth; and views and experiences of a publicly-funded home birth program, including intrapartum transfers.
  
  
  RESULTS
  of the 44% (74/167) of midwives who responded to the survey, the majority (86%) supported the introduction of a publicly-funded home birth model, and most considered that there was consumer demand for the model (83%). Most thought the model was safe for women (77%) and infants (78%). These views were stronger amongst midwives who had experience working in the program (compared with those who had not). Of the 25% (12/48) of doctors who responded, views were mixed; just under half-supported the introduction of a publicly-funded home birth model, and one was unsure. Doctors also had mixed views about the safety of the model. One third agreed it was safe for women, one third were neutral and one third disagreed. Half did not believe the home birth model was safe for infants. The majority of midwives (93%) and doctors (75%) believed that intrapartum transfers from home to hospital were easier when the homebirthing midwife was a member of the hospital staff (as is the case with these models).
  
  
  CONCLUSIONS
  responding midwives were supportive of the introduction of publicly-funded home birth, whereas doctors had divergent views and some were concerned about safety. To ensure the success of such programs it is critical that all key stakeholders are engaged at the development and implementation stages as well as in the ongoing governance.
authors.affiliation: Judith Lumley Centre, La Trobe University, 215 Franklin Street, Melbourne, VIC 3000, Australia; School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia. Electronic address: h.mclachlan@latrobe.edu.au.
authors.forename: Helen
authors.initials: H
authors.lastname: McLachlan
authors.affiliation: Department of General Practice, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Melbourne, Australia.
authors.forename: Heather
authors.initials: H
authors.lastname: McKay
authors.affiliation: School of Law, University of Canterbury, Private Bag 4800, Christchurch 8041, New Zealand.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Powell
authors.affiliation: Judith Lumley Centre, La Trobe University, 215 Franklin Street, Melbourne, VIC 3000, Australia.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Small
authors.affiliation: Judith Lumley Centre, La Trobe University, 215 Franklin Street, Melbourne, VIC 3000, Australia.
authors.forename: Mary-Ann
authors.initials: MA
authors.lastname: Davey
authors.affiliation: The Royal Women's Hospital, Locked Bag 300, Grattan Street & Flemington Road, Parkville, VIC 3052, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Cullinane
authors.affiliation: Judith Lumley Centre, La Trobe University, 215 Franklin Street, Melbourne, VIC 3000, Australia; School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Newton
authors.affiliation: Judith Lumley Centre, La Trobe University, 215 Franklin Street, Melbourne, VIC 3000, Australia; The Royal Women's Hospital, Locked Bag 300, Grattan Street & Flemington Road, Parkville, VIC 3052, Australia.
authors.forename: Della
authors.initials: D
authors.lastname: Forster
mesh_terms: D001291:Attitude of Health Personnel; D036861:Delivery, Obstetric / Q000191:economics / Q000379:methods; D005260:Female; D005380:Financing, Government / Q000379:methods; D006078:Government Programs; D006700:Home Childbirth / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D017146:Models, Organizational; D009721:Nurse Midwives; D061214:Patient Safety; D018743:Perinatal Care / Q000191:economics / Q000458:organization & administration; D010820:Physicians; D011247:Pregnancy; D015397:Program Evaluation; D014739:Victoria
keywords: Home birth; Maternity care; Models of care; Place of birth