We might also find a number of babies who had lethal congenital anomalies, who would not have survived no matter where they were born or who attended the birth; there may be important differences between
home and hospital populations with regard to whether these anomalies were detected prenatally and whether parents changed their birth plans because of it.
Not exact matches
Flint
and colleagues suggested that when midwives get to know the women for whom they provide care, interventions are minimised.22 The Albany midwifery practice, with an unselected
population, has a rate for normal vaginal births of 77 %, with 35 % of women having a
home birth.23 A review of care for women at low risk of complications has shown that continuity of midwifery care is generally associated with lower intervention rates than standard maternity care.24 Variation in normal birth rates between services (62 % -80 %), however, seems to be greater than outcome differences between «high continuity»
and «traditional care» groups at the same unit.25 26 27 Use of epidural analgesia, for example, varies widely between Queen Charlotte's
Hospital, London,
and the North Staffordshire NHS Trust.
And in Canada, where it appears safest of all, several studies have demonstrated that in carefully selected
populations, there is no difference between the number of babies who die at
home or in the
hospital.
If there were more midwife - led birthing centers, out - of -
hospital and home birthing for the low risk healthy
population, according to evidence based NICES recommendations, this would decrease the rates of invasive procedures
and hospital exposure to pathogens - especially resistant ones, that all increase risk of infection.
The highest rates of breastfeeding are observed among higher - income, college - educated women > 30 years of age living in the Mountain
and Pacific regions of the United States.60 Obstacles to the initiation
and continuation of breastfeeding include physician apathy
and misinformation,61 - 63 insufficient prenatal breastfeeding education, 64 disruptive
hospital policies, 65 inappropriate interruption of breastfeeding, 62 early
hospital discharge in some
populations, 66 lack of timely routine follow - up care
and postpartum
home health visits, 67 maternal employment68, 69 (especially in the absence of workplace facilities
and support for breastfeeding), 70 lack of broad societal support, 71 media portrayal of bottle - feeding as normative, 72
and commercial promotion of infant formula through distribution of
hospital discharge packs, coupons for free or discounted formula,
and television
and general magazine advertising.73, 74
Inclusion criteria were as follows: the study
population was women who chose planned
home birth at the onset of labor; the studies were from Western countries; the birth attendant was an authorized mid-wife or medical doctor; the studies were published in 1985 or later, with data not older than from 1980;
and data on transfer from
home to
hospital were described.
Although affluent
and urban women began having their babies in
hospitals, however, medically underserved
populations, such as rural women with limited access to
hospitals and poor women who couldn't afford to give birth in the
hospitals, continued to give birth at
home.
Her first job out of midwifery school was in a community health center
and hospital in Chicago attending both
home and hospital births to a diverse
population.
Outcomes of planned
home births compared to
hospital births in Sweden between 1992
and 2004: a
population - based register study.
Comparing intended
home and hospital births in a cohort of 529688 low risk pregnancies in primary care in the Netherlands, de Jonge et al recently found low rates of perinatal mortality (intrapartum
and neonatal death before 7 days)
and admission to the NICU.11 They concluded that an intended
home birth does not increase risks compared with an intended
hospital birth in this
population.
In my experiences with homebirth midwives that practice in Illinois (there is still a large Mennonite
population,
and a number of women who still wish to birth at
home), the recommend having a homebirth friendly Pediatrician in place because, «there are orders to call CPS if a homebirthed baby or mom transfers to a
hospital».
Steve Kell, GP
and co chair of the NHS Clinical Commissioners representative group, said: «CCGs are trying to develop a sense of joint responsibility for
populations, so people in the
hospital are thinking beyond their
hospital walls to look at nursing
home quality,
and anything that affects our patients.
«We wanted to determine the risk to help assess whether this
population of patients could safely go
home and do further outpatient testing within a day or two,» said Dr. Michael Weinstock, a professor of Emergency Medicine at The Ohio State University College of Medicine
and chairman of the Emergency Department at Mt. Carmel St. Ann's
Hospital.
Enhancing the quality of life through pets *: Supporting programs that train pets to become service animals for military veterans or people with disabilities
and for pet therapy programs in
hospitals, schools, senior
homes or with at - risk
populations.
Injured Workers
and Poverty Survey 2010 Many Losses, Much Hardship The Impact of Work Injury FAST FACTS • Before injury, 89 % were employed full time; after injury 9 % • Nearly one in five lost their
homes after injury • Nearly one quarter had moved in with family or friends at some point after their injuries • One in five injured workers could no longer afford a car • Food bank use rose from 5 to 77 people after work injury • 20 % reported an overnight
hospital stay the last 12 months (most because of the work injury) compared with 7 % for the general
population of Canadians • Over half had not been able to afford medications in the past 12 months • 57 % of injured workers in the study were unemployed For more information: wwwinjuredworkersonline.org
I have committed over 10 years to working with the psychogeriatric
population, typically people over the age of 65 who have been diagnosed with a serious mental illness, both in nursing
homes and through a city
hospital.
The scope of HV programs has been expanding to address special
populations and to include additional goals such as follow - up from
hospital discharge, medical visits to children who have special health care needs (eg, asthma care), hospice
and palliative care,
and environmental evaluations (eg,
home lead evaluations).
Although traditional models of primary care provide reactive
and episodic care during doctor visits, new models require outreach, coordination,
and education / empowerment with increasing teamwork provided by multidisciplinary staff including
home visitors.22 As FCMHs
and hospitals are increasingly being held accountable to
population quality measures, interest in
home visitation (HV)
and community health worker models have increased.23 For instance, Healthcare Effectiveness Data
and Information Set quality measures that assess well - child visit attendance of a primary care practice's panel has increased interest in medical
home outreach to families
and home visitation strategies.
Designed for practical
and sustainable delivery by care providers or educators, the curriculum is ideal for all age groups
and populations in places with limited resources, such as
hospitals, nursing
homes, schools, shelters,
and community clinics.