Evidence map›Paper›PMID 38409862›Full record

ArticleBirth (Berkeley, Calif.)2025

In search of respect and continuity of care: Hungarian women's experiences with midwifery-led, community birth.

Nicholas Rubashkin, Brianna Bingham, Petra Baji, Imre Szebik, Sarolta Kremmer, Saraswathi Vedam

Open access · hybridAbstract read
In one paragraph

Article in Birth (Berkeley, Calif.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.7field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 4 countries.

Nicholas RubashkinDepartment of Obstetrics, Gynaecology, & Reproductive Sciences, University of California at San Francisco, San Francisco, California, USA.
Brianna BinghamInstitute for Global Health Sciences, University of California at San Francisco, San Francisco, California, USA.
Petra BajiMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Imre SzebikInstitute of Behavioural Sciences, Semmelweis University Faculty of Medicine, Budapest, Hungary.
Sarolta KremmerProgram in Midwifery B.SC, Semmelweis University Faculty of Health Sciences, Budapest, Hungary.
Saraswathi VedamSchool of Population & Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.ORCID 0000-0001-6396-3638
Semmelweis University · HUGlobal Brain Health Institute · USUniversity of Bristol · GBUniversity of British Columbia · CAUniversity of California, San Francisco · US

Funding

WOMEN'S REPRODUCTIVE HEALTH RESEARCH CENTERK12HD001262 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Andrea Vashti Jackson · 1998 to 2026
$9.3M
Fullbright research 2K12HD001262NICHD NIH HHS K12 HD001262
6 · The paper itself

Abstract

introductionTo describe and compare intervention rates and experiences of respectful care when Hungarian women opt to give birth in the community.

methodsWe conducted a cross-sectional online survey (N = 1257) in 2014. We calculated descriptive statistics comparing obstetric procedure rates, respectful care indicators, and autonomy (MADM scale) across four models of care (public insurance; chosen doctor or chosen midwife in the public system; private midwife-led community birth). We used an intention-to-treat approach. After adjusting for social and clinical covariates, we used logistic regression to estimate the odds of obstetric procedures and disrespectful care and linear regression to estimate the level of autonomy (MADM scale).

findingsIn the sample, 99 (7.8%) saw a community midwife for prenatal care. Those who planned community births had the lowest rates of cesarean at 9.1% (public: 30.4%; chosen doctor: 45.2%; chosen midwife 16.5%), induced labor at 7.1% (public: 23.1%; chosen doctor: 26.0%; chosen midwife: 19.4%), and episiotomy at 4.44% (public: 62.3%; chosen doctor: 66.2%; chosen midwife: 44.9%). Community birth clients reported the lowest rates of disrespectful care at 25.5% (public: 64.3%; chosen doctor: 44.3%; chosen midwife: 38.7%) and the highest average MADM score at 31.5 (public: 21.2; chosen doctor: 25.5; chosen midwife: 28.6). In regression analysis, community midwifery clients had significantly reduced odds of cesarean (0.35, 95% CI 0.16-0.79), induced labor (0.27, 95% CI 0.11-0.67), episiotomy (0.04, 95% CI 0.01-0.12), and disrespectful care (0.36, 95% CI 0.21-0.61), while also having significantly higher average MADM scores (5.71, 95% CI 4.08-7.36).

conclusionsHungarian women who plan to give birth in the community have low obstetric procedure rates and report greater respect, in line with international data on the effects of place of birth and model of care on experiences of perinatal care.

Indexed as

Continuity of Patient CareDelivery, ObstetricHome ChildbirthMidwiferyPrenatal CareRespectAdultCesarean SectionCross-Sectional StudiesEpisiotomyFemaleHumansHungaryLabor, InducedLogistic ModelsPatient Satisfactioncesareancommunity birthHungarymother–baby‐friendly care

Identifiers

PMID38409862
PMCPMC11345881
OpenAlexW4392194515

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.