Program

Nurse-Midwifery M.S.

Number of Pages

54

Year Approved

2025

First Advisor

Hardy, Paige

Second Reader

Katrina Wu

Abstract

Introduction: The goal of this literature review is to determine the safety of community birth by evaluating if low-risk pregnant women at term, who deliver in the community setting, specifically at freestanding birth centers, have comparable or lower maternal and neonatal morbidity and mortality outcomes, than low-risk women who deliver at an in-hospital birthing facility.

Methods: The authors of this integrative review retrieved original research articles from computerized databases (Nursing and Allied Health, PubMed, and CINAHL), as well as online journal hand searching, followed by cited reference searching. A total of 48 articles underwent a full-text review, and a total of 21 articles met the criteria for inclusion.

Results: Overall, there was a complicated correlation between newborn mortality and the place of birth. However, when qualified midwives attended planned community deliveries, research that considered the presence of pre-existing risk factors and the qualifications of delivery attendants frequently showed a convergence towards comparable newborn outcomes. It was also frequently noted that hospital settings had greater rates of maternal morbidity, particularly in relation to postpartum hemorrhage and perineal injuries. Additionally, the concept of risk perception and informed choice surfaced as a crucial element impacting choices about where to give birth. A less intervention-driven experience, autonomy, and a holistic approach were frequently sought by women who chose to give birth outside of hospitals.

Discussion: Comprehensively, the cited research supports the use of freestanding birth centers as a safe alternative to the hospital setting for low-risk pregnant patients. Outcomes overall are at minimum comparable to the hospital setting and in some cases the risk of morbidity is reduced just by receiving prenatal care at a freestanding birth center. All low-risk pregnant patients should be presented with the option of receiving care and/or delivering at a freestanding birth center to ensure equal access to information is offered and informed choices are made.

Degree Name

M.S. Nurse-Midwifery

Document Type

Masterʼs thesis

Terms of Use and License Information

Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Download

Share

COinS