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Praxis and guidelines for planned homebirths in the Nordic countries – An overview

Helena Lindgrena, Hanne Kjaergaard, Olof Asta Olafsdottir, Ellen Blixg

Sexual & Reproductive Healthcare, Volume 5, Issue 1, March 2014, Pages 3–8
 

Editor’s comment: Prof. Jim Thornton: Home birth in Nordic countries
According to official guidelines from Denmark, Iceland, Norway, and Sweden, only in Denmark is there a right to be attended at home birth by a state-funded midwife. Elsewhere home birth is either not mentioned, or discouraged, and women often need to pay for a private midwife. Sweden has the lowest home birth rate at 0.6/1000 and, apart from a small area around Stockholm, all Swedish women pay privately.

Abstract

Objective

The objective of this overview was to investigate the current situation regarding guidelines and praxis for planned homebirths and also to investigate possibilities for comparative studies on planned homebirths in the Nordic countries (Denmark, Iceland, Norway, Finland and Sweden).

Design and setting

National documents on homebirth and midwifery and recommendations regarding management and registration of planned homebirths in the included countries were investigated.

Findings

Guidelines regarding planned home birth were found in four of the included countries. In Denmark any woman has the right to be attended by a midwife during a homebirth and each county council must present a plan for the organization of birth services, including homebirth services. In Norway and Iceland the service is fully or partly funded by taxes and national guidelines are available but access to a midwife attending the birth varies geographically. In the Stockholm County Council guidelines have been developed for publicly funding of planned home births; for the rest of Sweden no national guidelines have been formulated and the service is privately funded.

Key conclusion

Inconsistencies in the home birth services of the Nordic countries imply different opportunities for midwifery care to women with regard to their preferred place of birth. Uniform sociodemography, health care systems and cultural context in the Nordic countries are factors in favour of further research to compare and aggregate data on planned home births in this region. Additional data collection is needed since national registers do not sufficiently cover the planned place of birth.

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Commentaries by Editor Prof. Jim Thornton