Exploring models of maternity care that support home birth
Research type
Research Study
Full title
Home birth and the NHS: Exploring the dynamics of organisational change in the context of care
IRAS ID
164243
Contact name
Emma Rowley
Contact email
Duration of Study in the UK
1 years, 9 months, 30 days
Research summary
Healthcare systems are notoriously difficult to change. Even where evidence-based interventions exist, policy imperatives, institutional pressures and professional cultures often impede change. The aim of this study is to understand and explain the activity involved in introducing and sustaining new models of health service organisation and delivery, with a specific focus on models of care to support home birth.
Specifically, this study will investigate and compare instances where service configurations operate within institutional constraints. This study will take as its focus models of maternity care to support home births, which often face resistance from established acute maternity care providers and commissioners, despite established and growing evidence that home birth is statistically safer for low risk pregnant women than obstetric unit birth; that large scale research into the cost-effectiveness of home birth demonstrates the potential to deliver significant cost savings for the NHS; and that those women and families who experience home births report increased levels of service satisfaction. As such, this study will provide meaningful lessons for health service leaders looking to make change as well as academic communities interested in the dynamic processes of institutional work.
This study will take place between November 2014 and October 2016. It will focus on three case sites that represent a range of settings, conditions and relationships familiar to English maternity services. Case sites will be chosen which provide opportunities to compare services that have changed and improved their performance over time, or that have significantly higher levels of home birth than their geographical neighbours, or where women have a choice of different home birth providers in their locality. It will involve face-to-face interviews and closed online discussion forums with commissioners, service leaders and providers, and focus groups with service users and/or representatives.
REC name
East Midlands - Nottingham 2 Research Ethics Committee
REC reference
15/EM/0056
Date of REC Opinion
26 Mar 2015
REC opinion
Further Information Favourable Opinion