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      Between a Rock and a Hard Place: Considering “Freebirth” During Covid-19

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          Abstract

          Background: The global coronavirus (Covid-19) pandemic concerns all people, but has a specific effect on those who are expecting a baby during this time. The advice in the UK changed rapidly, with 14 different sets of national guidance issued within 1 month. Individual NHS Trusts released various guidance relating to the withdrawal of homebirth services, the closure of birth centers, restrictions on the number of birth partners (if any) allowed during labor, and whether any visitors were allowed to attend after birth. With the landscape of maternity care changing so rapidly, research was carried out to provide real-time data to capture the lived experiences of expectant families.

          Methods: A mixed methods online survey was carried out over 2 weeks between 10th and 24th April 2020. The survey was open to those in the third trimester of pregnancy, those who had given birth since the beginning of the “lockdown” period in the UK, and the partners of pregnant women and people who were in these circumstances. The survey asked questions about how respondents' holistic antenatal experiences had been affected, whether their plans for birth had changed, and the effect of these changes on respondents' emotional wellbeing. Of the 1,700 responses received, 72 mentioned that they had seriously considered “freebirthing” (giving birth without a healthcare professional present).

          Findings: An analysis of the respondents' reasons for considering freebirth was conducted, finding that reasons for considering freebirth were complex and multifaceted. Lesbian, bisexual, pansexual, and queer women were more likely to have considered freebirth than heterosexual people ( p < 0.001).

          Conclusions: Considering giving birth without a healthcare professional present is unusual in the Global North and represents an emerging field of study. The literature examining the reasons that people consider freebirth shows a variety of underlying motivations. A global pandemic represents a new factor in such considerations. The findings from this research can help inform maternity service planning in future crises.

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          Using thematic analysis in psychology

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            Transgender men who experienced pregnancy after female-to-male gender transitioning.

            To conduct a cross-sectional study of transgender men who had been pregnant and delivered after transitioning from female-to-male gender to help guide practice and further investigation.
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              Birthing outside the system: perceptions of risk amongst Australian women who have freebirths and high risk homebirths.

              homebirth for low risk women attended by competent midwives who are networked within a responsive maternity care service is supported by research as safe. Concerns exist over the safety of homebirths which are unattended by trained health professionals, or for women with medically defined risk factors. Both these birth choices are unsupported by mainstream maternity care options in Australia and therefore represent birth choices considered to be 'outside the system'. to explore the perceptions of risk held by women who choose to have a freebirth (birth at home intentionally unattended by a trained birth attendant) or a 'high-risk' homebirth (professionally attended home birth where a mother or baby has medically defined risk factors). Both of these choices are considered to be 'outside the system'. twenty women were interviewed about their choice to 'birth outside the system', nine choosing freebirth and 11 choosing to have an attended homebirth despite the presence of medically defined risk factors; three were primiparous and seventeen were multiparous. Women intending to have, or having had a freebirth or high risk homebirth, were interviewed using semi-structured interviews. Interviews were transcribed and analysed using thematic analysis. the three main themes about perceptions of risk that were evident in this study were: 'Birth always has an element of risk', 'The hospital is not the safest place to have a baby'; and 'interference is a risk'. the participants acknowledge that birth is a time in life that carries an element of risk. They perceive that hospital represents a more risky place to give birth than at home and that interventions and interruptions during labour and birth increase risk. Women who birth outside the system perceive the risks of birth in hospital differently to most women. These women feel that by birthing outside the system they are making a choice that protects them and their babies from the risks associated with birthing in hospital and thus provides them with the best and safest birthing option. in pursuing the best for themselves and their babies, women who birth outside the system spent a lot of time and energy considering the risks and weighing these up. For them birth in hospital is considered less safe than birth at home. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Front Glob Womens Health
                Front Glob Womens Health
                Front. Glob. Womens Health
                Frontiers in Global Women's Health
                Frontiers Media S.A.
                2673-5059
                18 February 2021
                2021
                18 February 2021
                : 2
                : 603744
                Affiliations
                [1] 1King's College London , London, United Kingdom
                [2] 2University of Hertfordshire , Hatfield, United Kingdom
                Author notes

                Edited by: Marianne Vidler, University of British Columbia, Canada

                Reviewed by: Folasade Adenike Bello, University of Ibadan, Nigeria; Caroline Susan Elizabeth Homer, Burnet Institute, Australia

                *Correspondence: Mari Greenfield mari.greenfield@ 123456kcl.ac.uk

                This article was submitted to Maternal Health, a section of the journal Frontiers in Global Women's Health

                Article
                10.3389/fgwh.2021.603744
                8594025
                34816178
                59c480eb-c777-4312-9403-d8176901d933
                Copyright © 2021 Greenfield, Payne-Gifford and McKenzie.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 07 September 2020
                : 25 January 2021
                Page count
                Figures: 3, Tables: 3, Equations: 0, References: 28, Pages: 11, Words: 8427
                Funding
                Funded by: UK Research and Innovation, doi 10.13039/100014013;
                Categories
                Global Women's Health
                Original Research

                freebirth,pregnancy,choice,covid-19,maternity,childbirth,lgbtq+
                freebirth, pregnancy, choice, covid-19, maternity, childbirth, lgbtq+

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