Birthplaces
The guideline mentions all places that are known:
- Hospital births in the physician-led delivery room,
- midwife-led delivery room, and
- outpatient attended birth with the patient's own midwife.
- Birth center (documentation of out-of-hospital births, see (2)).
- Home births (births in the home environment), (guideline table 9, p. 13).
Women should be informed about what to expect at different birthplaces.
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Ask, for example: - Where is there one-to-one care by a midwife? - Is medical assistance nearby if needed? - How is pain managed, medicinally or physiologically? - What happens if a woman says no to a proposed treatment? - If the first baby was delivered by cesarean section, is it made possible to try to deliver vaginally? - What if a baby wants to come buttom first (called breech presentation) or twins are expected? (3.2)(16)
In principle, the woman should be informed about the possibilities of the respective place of birth.
"... personal views and judgments regarding their choice (should) be avoided in favor of objective advice." (3.4) Up to now, there has been no official document in which the 5 places of birth are presented side by side and thus acknowledged. It is the result of years of advocacy by many parents and parents' initiatives, midwives, doctors and psychologists for a reform of our birth culture.
(2) Out-of-hospital births in birth centers and at home are documented. At www.quag.de you will find an official quality report in German for each year.
(16) These numbers refer to the location in the abbreviated version of the guideline "Vaginal Birth at Term."