Shared responsibility in home birth practice: Collaborating with clients

The home setting not only provides a special environment for birth and the practice of midwifery. but also has an impact on the processes used in clin ical decision making. This article focuses on collaboration between the mid wife and the birthing woman and also discusses the collaborative relationsh ip between midwives and obstetric consultants. A home birth cast: study ill ustrates the interactions among the midwife, the woman. and the medical sys tem. These critical relationships provide structure for safe, effective cli nical practice in planned home birth when practice boundaries are not defin ed by institutional walls. (C) 2000 by the American College of Nurse-Midwiv es.