Bmc Pregnancy Childb
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Bmc Pregnancy Childb · Jun 2014
EditorialThe CROWN initiative: journal editors invite researchers to develop core outcomes in women's health.
Clinical trials, systematic reviews and guidelines compare beneficial and non-beneficial outcomes following interventions. Often, however, various studies on a particular topic do not address the same outcomes, making it difficult to draw clinically useful conclusions when a group of studies is looked at as a whole. ⋯ There is a growing recognition among clinical researchers that this variability undermines consistent synthesis of the evidence, and that what is needed is an agreed standardised collection of outcomes--a "core outcomes set"--for all trials in a specific clinical area. Recognising that the current inconsistency is a serious hindrance to progress in our specialty, the editors of over 50 journals related to women's health have come together to support The CROWN (CoRe Outcomes in WomeN's health) Initiative.
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Bmc Pregnancy Childb · Jun 2014
An exploration of influences on women's birthplace decision-making in New Zealand: a mixed methods prospective cohort within the Evaluating Maternity Units study.
There is worldwide debate surrounding the safety and appropriateness of different birthplaces for well women. One of the primary objectives of the Evaluating Maternity Units prospective cohort study was to compare the clinical outcomes for well women, intending to give birth in either an obstetric-led tertiary hospital or a free-standing midwifery-led primary maternity unit. This paper addresses a secondary aim of the study--to describe and explore the influences on women's birthplace decision-making in New Zealand, which has a publicly funded, midwifery-led continuity of care maternity system. ⋯ Birthplace is a profoundly important aspect of women's experience of childbirth. This is the first published study reporting New Zealand women's perspectives on their birthplace decision-making. The groups' responses expressed different ideologies about childbirth. The tertiary hospital group identified with the 'medical model' of birth, and the primary unit group identified with the 'midwifery model' of birth. Research evidence affirming the 'clinical safety' of primary units addresses only one aspect of the beliefs influencing women's birthplace decision-making. In order for more women to give birth at a primary unit other aspects of women's beliefs need addressing, and much wider socio-political change is required.