A true choice of place of birth? Swiss women's access to birth hospitals and birth centers.
While the place of birth plays a crucial role for women's birth experiences, the interest in out-of-hospital births has increased during the Covid-19 pandemic. Related to this, various international policies recommend enabling women to choose where to give birth. We aimed to analyze Swiss women...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0270834 |
| _version_ | 1818041975492837376 |
|---|---|
| author | Sebastian Rauch Louisa Arnold Zelda Stuerner Juergen Rauh Michael Rost |
| author_facet | Sebastian Rauch Louisa Arnold Zelda Stuerner Juergen Rauh Michael Rost |
| author_sort | Sebastian Rauch |
| collection | DOAJ |
| description | While the place of birth plays a crucial role for women's birth experiences, the interest in out-of-hospital births has increased during the Covid-19 pandemic. Related to this, various international policies recommend enabling women to choose where to give birth. We aimed to analyze Swiss women's choice between birth hospitals and birth centers. Employing spatial accessibility analysis, we incorporated four data types: highly disaggregated population data, administrative data, street network data, addresses of birth hospitals and birth centers. 99.8% of Swiss women of childbearing age were included in the analysis (N = 1.896.669). We modelled car travel times from a woman's residence to the nearest birth hospital and birth center. If both birth settings were available within 30 minutes, a woman was considered to have a true choice. Only 58.2% of women had a true choice. This proportion varied considerably across Swiss federal states. The main barrier to a true choice was limited accessibility of birth centers. Median travel time to birth hospitals was 9.8 (M = 12.5), to birth centers 23.9 minutes (M = 28.5). Swiss women are insufficiently empowered to exercise their reproductive autonomy as their choice of place of birth is significantly limited by geographical constraints. It is an ethical and medical imperative to provide women with a true choice. We provide high-resolution insights into the accessibility of birth settings and strong arguments to (re-)examine the need for further birth centers (and birth hospitals) in specific geographical areas. Policy-makers are obligated to improve the accessibility of birth centers to advance women's autonomy and enhance maternal health outcomes after childbirth. The Covid-19 pandemic offers an opportunity to shift policy. |
| first_indexed | 2024-12-10T08:38:58Z |
| format | Article |
| id | doaj.art-15bd8088368341b38fe9115f1ceba5c4 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T08:38:58Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-15bd8088368341b38fe9115f1ceba5c42022-12-22T01:55:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01177e027083410.1371/journal.pone.0270834A true choice of place of birth? Swiss women's access to birth hospitals and birth centers.Sebastian RauchLouisa ArnoldZelda StuernerJuergen RauhMichael RostWhile the place of birth plays a crucial role for women's birth experiences, the interest in out-of-hospital births has increased during the Covid-19 pandemic. Related to this, various international policies recommend enabling women to choose where to give birth. We aimed to analyze Swiss women's choice between birth hospitals and birth centers. Employing spatial accessibility analysis, we incorporated four data types: highly disaggregated population data, administrative data, street network data, addresses of birth hospitals and birth centers. 99.8% of Swiss women of childbearing age were included in the analysis (N = 1.896.669). We modelled car travel times from a woman's residence to the nearest birth hospital and birth center. If both birth settings were available within 30 minutes, a woman was considered to have a true choice. Only 58.2% of women had a true choice. This proportion varied considerably across Swiss federal states. The main barrier to a true choice was limited accessibility of birth centers. Median travel time to birth hospitals was 9.8 (M = 12.5), to birth centers 23.9 minutes (M = 28.5). Swiss women are insufficiently empowered to exercise their reproductive autonomy as their choice of place of birth is significantly limited by geographical constraints. It is an ethical and medical imperative to provide women with a true choice. We provide high-resolution insights into the accessibility of birth settings and strong arguments to (re-)examine the need for further birth centers (and birth hospitals) in specific geographical areas. Policy-makers are obligated to improve the accessibility of birth centers to advance women's autonomy and enhance maternal health outcomes after childbirth. The Covid-19 pandemic offers an opportunity to shift policy.https://doi.org/10.1371/journal.pone.0270834 |
| spellingShingle | Sebastian Rauch Louisa Arnold Zelda Stuerner Juergen Rauh Michael Rost A true choice of place of birth? Swiss women's access to birth hospitals and birth centers. PLoS ONE |
| title | A true choice of place of birth? Swiss women's access to birth hospitals and birth centers. |
| title_full | A true choice of place of birth? Swiss women's access to birth hospitals and birth centers. |
| title_fullStr | A true choice of place of birth? Swiss women's access to birth hospitals and birth centers. |
| title_full_unstemmed | A true choice of place of birth? Swiss women's access to birth hospitals and birth centers. |
| title_short | A true choice of place of birth? Swiss women's access to birth hospitals and birth centers. |
| title_sort | true choice of place of birth swiss women s access to birth hospitals and birth centers |
| url | https://doi.org/10.1371/journal.pone.0270834 |
| work_keys_str_mv | AT sebastianrauch atruechoiceofplaceofbirthswisswomensaccesstobirthhospitalsandbirthcenters AT louisaarnold atruechoiceofplaceofbirthswisswomensaccesstobirthhospitalsandbirthcenters AT zeldastuerner atruechoiceofplaceofbirthswisswomensaccesstobirthhospitalsandbirthcenters AT juergenrauh atruechoiceofplaceofbirthswisswomensaccesstobirthhospitalsandbirthcenters AT michaelrost atruechoiceofplaceofbirthswisswomensaccesstobirthhospitalsandbirthcenters AT sebastianrauch truechoiceofplaceofbirthswisswomensaccesstobirthhospitalsandbirthcenters AT louisaarnold truechoiceofplaceofbirthswisswomensaccesstobirthhospitalsandbirthcenters AT zeldastuerner truechoiceofplaceofbirthswisswomensaccesstobirthhospitalsandbirthcenters AT juergenrauh truechoiceofplaceofbirthswisswomensaccesstobirthhospitalsandbirthcenters AT michaelrost truechoiceofplaceofbirthswisswomensaccesstobirthhospitalsandbirthcenters |