Women's experiences of planning a home birth with maternity care providers in middle-to high-income countries: A systematic review protocol

Background: A woman’s choice of birthplace does not only influence her birth experience, but also impacts on maternal and neonatal outcomes. For healthy women who have had a straightforward pregnancy, a planned home birth supported by midwives and other maternity care providers, is now a recognised choice within their individual country’s health care system. However, there is limited evidence on women’s actual experiences of engaging with maternity care providers to plan for a home birth, especially within the context of middle to high-income countries where there is integration of maternity care services. Therefore, this systematic review will synthesise findings from previous studies, which have reported on women’s experiences of planning a home birth in consultation with maternity care providers, in middle to high-income countries. We anticipate that primarily, qualitative studies will be located, as the focus of the review is on experiences of women.

Methods: Using a systematic approach, we will develop a search strategy to identify relevant research studies on women’s experiences of planning a home birth, with the support of their maternity care providers. Search terms will be iteratively developed using text words derived from the review aim and the PICO framework and database-indexed terms (Population: Women who planned or are planning a home birth within the context of a middle or high-income country; Intervention: Planning home birth with maternity care providers, Comparison: None applicable and Outcome: Experiences).

Searches will be undertaken on seven bibliographic databases: Ovid Medline, Embase, PsycInfo, and CINAHL plus, Scopus, ProQuest and Cochrane (Central and Library). Supplementary searches will also be undertaken to identify additional articles including grey literature. At least two reviewers will do the screening, quality appraisal, data extraction and analysis. Included studies will be appraised using a quality appraisal tool suited to the study design. Data will be analysed depending on the methodological design of the studies included (i.e. if all qualitative studies are included a thematic synthesis will be undertaken).

Expected Outcome: Review findings will provide useful recommendations to improve care and support provided for women when planning a home birth. We will publish review findings in a peer-reviewed journal and present it at relevant conferences while also sharing summaries with maternity care providers and service users via social media fora.