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Reconceptualising risk: Perceptions of risk in rural and remote maternity service planning
Barclay, Lesley Kornelsen, Jude Longman, Jo Robin, Sarah Kruske, Sue Kildea, Sue Verlie Pilcher, Jennifer Martin, Tanya Grzybowski, Stefan Donoshue, Deborah Anne
Barclay, Lesley
Kornelsen, Jude
Longman, Jo
Robin, Sarah
Kruske, Sue
Kildea, Sue Verlie
Pilcher, Jennifer
Martin, Tanya
Grzybowski, Stefan
Donoshue, Deborah Anne
Abstract
Objective: To explore perceptions and examples of risk related to pregnancy and childbirth in rural and remote Australia and how these influence the planning of maternity services. Design: Data collection in this qualitative component of a mixed methods study included 88 semi-structured individual and group interviews ( n=102 ), three focus groups ( n=22 ) and one group information session ( n=17 ). Researchers identified two categories of risk for exploration: health services risk ( including clinical and corporate risks ) and social risk ( including cultural, emotional and financial risks ). Data were aggregated and thematically analysed to identify perceptions and examples of risk related to each category. Setting: Fieldwork was conducted in four jurisdictions at nine sites in rural ( n=3 ) and remote ( n=6 ) Australia. Participants: 117 health service employees and 24 consumers. Measurements and findings: Examples and perceptions relating to each category of risk were identified from the data. Most medical practitioners and health service managers perceived clinical risks related to rural birthing services without access to caesarean section. Consumer participants were more likely to emphasise social risks arising from a lack of local birthing services. Key conclusions: Our analysis demonstrated that the closure of services adds social risk, which exacerbates clinical risk. Analysis also highlighted that perceptions of clinical risk are privileged over social risk in decisions about rural and remote maternity service planning. Implications for practice: A comprehensive analysis of risk that identifies how social and other forms of risk contribute to adverse clinical outcomes would benefit rural and remote people and their health services. Formal risk analyses should consider the risks associated with failure to provide birthing services in rural and remote communities as well as the risks of maintaining services.
Keywords
risk, risk assessment, rural health, health, health planning, birthing centres
Date
2016
Type
Journal article
Journal
Midwifery
Book
Volume
38
Issue
Page Range
63-70
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
File Access
Open
Notes
©2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/).