U.S. Healthcare Provider Views and Practices Regarding Planned Birth Setting

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Healthcare Provider Perspectives

Background:

• Limited understanding of U.S. healthcare provider practices regarding birth settings.
• Focus on evidence, counseling, and shared decision-making for in-hospital vs. out-of-hospital births.

Purpose of the Study:

• To explore U.S. healthcare provider views on in-hospital vs. out-of-hospital birth settings.
• To understand provider interpretation of evidence, counseling, and decision-making processes.

Main Methods:

• 19 in-depth, semistructured qualitative interviews.
• Participants included obstetricians, midwives, and pediatricians across the U.S.
• Explored provider experiences within the U.S. medical, ethical, and legal context.

Main Results:

• Ideological tensions identified between in- and out-of-hospital providers regarding risk-benefit value.
• Physicians cited U.S. data on increased neonatal risk with delayed hospital care; midwives cited European data on better outcomes with out-of-hospital births.
• Providers revealed a gap in anticipatory counseling on birth settings and noted asymmetric power dynamics.

Conclusions:

• Common goal of optimizing maternal and neonatal outcomes despite divergent risk prioritization.
• Findings suggest opportunities for collaboration through mutual respect and integrated care.
• Highlights need for improved communication and shared decision-making in birth setting choices.