Landscape of a health policy analysis “provides the overall context for analysis by identifying key stakeholders and the factors that must be considered when analyzing the problem.” This is a critically important part of analyzing policy, so we focus on this in this specific case study. First, provide a problem statement, example (Should Teenage Pregnancy be a Problem for the State?). This sets the stage for your analysis, as it is critically important in a policy analysis and should be clearly articulated within the first couple of paragraphs. Provide a brief background on this problem for the client/reader, defining and detailing the key elements and issues of the problem to set the stage for your landscape. Develop a landscape section for home versus hospital births utilizing all factors (political, social, economic, practical, legal, and quality of care). In your narrative, please address all questions/concerns related to the factors Save your paper as a word document. Case study should be Arial, Calibri, Cambria or Times New Roman font, size 12pt, double-spaced, with 1 inch margins. All sources/references cited within text per APA style, as well as with a separate reference page per APA style. Be sure to use and cite the video for the case study- 2008 The Business of Being Born. The length of your response for each Case Study is 2-4 pages (double-spaced). Cover and reference pages do not count towards the page requirements. Please note the page requirements- no less than two, no more than four. 1 3⁄4 pages does not meet the minimum requirements. Do not place your name, course title, assignment name, etc. in the body of your text. Use a cover page for these elements that is not part of the page length requirements. This case study sets the stage for the beginning of a policy analysis, so it is like a paper in some respects. Lay out your Problem Statement, Background, and Landscape as formal sections.


Policy Analysis Case Study

Student’s Name

Institution Affiliation


Date of Submission


Problem Statement

Teenage pregnancy is viewed to be the pregnancy in females under the age of nineteen, and it is considered to be an essential issue with some explanations; for instance, the infants delivered by teenage mothers face health risks. They are also prone to go through from social, health and disturbing issues than the kids born to grown-up mothers. Teenage pregnancy is typically associated with increased dangers for medical complications which include premature labor and social challenges. As observed by the Centers for Disease Control and Prevention (CDC), the rate of teenage delivery in the United States was rated at 14 percent births for every 1,200 teens in 2010.

The teenage pregnancy has become a problem in the United States as the levels stay high and close to 1.5 million adolescent girls become expectant in every year within the States. In the United States, the overall cost of adolescent pregnancies generated from lost income tax revenues, public support, child health care, the foster care and illegal justice system is viewed to be close to $7.5 billion. Therefore, adolescent pregnancy has become a significant predicament within the States and the government should create adequate measures that should be implemented to reduce this problem. For instance, they should be informed on sex and sexuality and the general negative effects of pregnancy (Lindgren et al. 2010).

Background of the Problem

The teenage pregnancy problem did not exist in the human culture and throughout the human history together with that of the United States; adolescent childbearing was popular with girls engaging in marriage with as low as 12 to 15 years old. In the 19th century, with the emergence of the reform movement, the essential views of the people engaged in reforming process shifted to avoiding illegitimacy within young expectant girls, more so the ones who lived in the growing urban areas. Also, the era led to the increase of maternity homes, orphanages, and “wayward girls” homes which were managed and controlled by religious and charitable institutions. The idea of the teenager and their outgrowing culture came into existence during the early 1940s where the teenage pregnancy began to acquire a visible role in the American popular culture inclusive of the literature and films. Underage girls who had children began to be regarded as a serious moral issue that was an indication of self-control (Watterberg et al. 2013). In the early fifties up to date, there existed a notion that some girls were more likely to engage in premarital sex and fall pregnant, one who originated from a lower socioeconomic status and ethnic minority.


Home Births

The process of home births in well-developed countries is viewed to be an attended or an unattended childbirth in a non-clinical environment with the typical use of natural childbirth techniques. Several home births take place in a residence setup rather than in a maternal surrounding and are typically attended to by a midwife or a lay supporter having an experience in controlling and successfully achieving home births (Wax et al. 2010). In the modern society, home birth rates have reduced more so in the developed countries with a percentage of one out of the entire births. Women who can access high-quality medical health care can choose home births due to the intimacy associated with a home and family-centered knowledge or the urge to evade a hospital-centered expertise. Some of the people related to acquiring a successful home birth process include the obstetricians, certified or uncertified midwives, and the doulas. In the third world countries, females may not be able to acquire medical care or the healthcare services may not be available to them; hence, a home birth may be the only solution obtainable, and they may not be helped by specialized attendants.

Over the course of human history, medical, economic, political and social perceptions have created the change in practices involved with childbirth inclusive of where and under whose supervision the process should take place. One of the dramatic changes as observed in the developed countries is the move of delivery from home to the hospital. This has been the case in the 20th century where male doctors have been included in the domain that was previously dominated by the female doctors and the application of medical technologies. Some regulations have been put in place concerning home births that regulates the duties of midwives, however, experienced they might be. There has been a change in the law that was implemented in May 2017 which explicitly allow home births for a specific younger mother examined to be having uncomplicated pregnancies. Despite these factors, many countries still oppose the home birth procedure with insurance companies failing to pay for the mothers (Watterberg et al. 2013).

Modern American has a lot to discuss the rights and opportunities for women in birthing; however, when it comes to the act of nurturing and bringing their children safely to birth, American women typically find their actions severely restricted. Fifteen states have resolved to enact laws which prohibit unlicensed midwifery while others have decided to prosecute the individuals operating without any license. Several midwives have responded to the issues through ignoring the regulations, some have gone silent; others have been indicted while others imprisoned. These factors have led to a majority of these individuals ceasing the practice hence failing to pass their skills on to the new generation. After investigating the health implications of different options to childbirth, Word Health Organization (WHO) have come up with a “Report on Appropriate Technology for Birth” which seeks for a better emphasis on the exciting and collective factors (Lindgren et al. 2010). The report rejects many common obstetrical practices which also involves regular uses electronic fetal monitors or medications during the labor process. Since a majority of regulations concerning midwifery are hectic to enforce, the legal threat takes typically the direction of intimidation generated from the medical and welfare groups, accompanied with a few arrests and raids.

Quality of Care

Many women and their families may have the desire to embrace home birth due to many reasons inclusive of the hopes for a more family-friendly environment, a boost in the control of the entire procedure, decreased obstetric intervention, and reduced cost. Even though the practice of home birth is still at a lower rate of one percent of the total births in the United States, the degree of the method has increased over the past years for the white, non-Hispanic women (Wax et al. 2010). The idea of home birth has not been supported in the US due to the massive variation in the laws and regulations, lack of adequately trained and willing providers and lack of necessary systems for transport purposes. As observed by the midwifery and Women’s Health newspaper, it confirms that among the low-risk females, planned home births typically result in low degrees of interventions without fluctuation in the feedbacks for mothers and babies.

The feedback of a majority of studies together with the development of the MANA Stats registry has confirmed the safety that is associated with home birth which has possess definite health advantages for low-risk mothers and infants who choose to birth at home with a midwife. In the entire process, midwives typically provide an excellent care which makes it safe for the women to deliver successfully. Moreover, a correctly planned home birth with the professionals is not only conducive to the babies and mothers with low-risk pregnancies but also leads to health and cost advantages that reach beyond one pregnancy. However, there are cases when home births and the use of midwives may not be applicable; for instance; there are conditions in which the infant and the mother will need medical interventions that are beyond the scope of services offered by a midwife (Watterberg et al. 2013). Therefore, when a woman has risk pregnancy or if complications are predictable, it thus necessary to choose a hospital setting with more convenient access to obstetricians and other trained persons that will address difficulties affecting either the mother or baby.

Hospital Births


Infirmary deliveries have used the mutual influence which has made a lot of variations in this era. Although giving birth itself has not reformed at all, where children are still native currently in the same way they have been congenital for age band. However, many of the stuff related to childbearing who includes: ache managing choices, the skill used throughout gestation and natal, and females’ prospects of giving birth (Simpson, 2011). On the same note, womankind having a baby in a commercial state can rationally believe that in cooperation she and her child will have a vigorous passage over confinement and delivery. Therefore, this makes a gestation to be commonly harmless and does not signify sickness or ill health. However, many years ago some females tackled childbearing with some distress because they knew of a mother or baby who had passed away. Currently, conversely, there are specific opportunities those variations in delivery expertise not only to lessen the dangers that strength which has headed to demise or incapacity a period ago but assured a flawless result (Simpson, 2011). Furthermore, in many parts of the sphere now, females can, therefore, strategize their gestations and incline to have fewer kids than an era ago. Moreover, opportunities for discomfort supervision have also transformed. For instance, one hundred pages before, most offspring all over the sphere was congenital at home (Simpson, 2011). However, various aspects have funded to the drive of delivery from the house to the hospital, the reason being the advancement in ache decreasing childbearing anesthesia which was only accessible at the hospital.


Financial side improvement has taken place during the infirmary deliveries in various ways over the time. Moreover, some of these ideas were the accessibility of aching treatments in the hospital, females’ and doctor’s viewing that hospital confinements being harmless and the confidence that surgeons were the best competent person to be present during childbirth (Simpson, 2011). On the other hand, medical doctors and sickbays are also being accepted that if there is a definite association recognized by an expectant woman, then it will encourage where she always hunts for attention for herself and her family for a lifespan. Therefore, during the early 20th century and ongoing today, the hospitals continued that they could advance revenue from given that amenities as well as provide a place to give natal. Epidural or spinal anesthesia, effort training, cesarean segments even in the location of IV appearances are also the causes of extra profits for both the hospital and the expert have tangled. However, from the standpoint of the hospital, a little interference standard delivery is not the most monetarily commerce (Simpson, 2011).


According to the political in hospital births where the donation of the official agenda is presented regarding assemblies that help in stipulating of the new influential and executive activities which are vital beneath the dispersed scheme (Yassaei, 2010). Moreover, the plans have a habit of admitting the necessity for the new power and board provisions at both levels of politics. Therefore, governments have also the capacity to convey competent, fee active and impartial strength amenities to the inhabitants and at the same time, it helps in recruiting and supporting investor input and liability in the fitness in facility distribution, supervision, and organization.


Deployment of real dynamic in infirmary parturitions through the use of the warm water during the labor has played an enormous role in giving a wellbeing extent. For instance, it is broadly accessible, harmless and operational. Furthermore, warm water engagements in efforts can weaken the pressure hormones which are the catecholamine’s that raises the soreness and gentling the labor. On the other hand, the other applied influence is also used as water birth which has got numerous reimbursements for the kid as well and frequently offers a moderate evolution to life outside the womb (Yassaei, 2010). Nevertheless, many expecting females are tense to water, particularly in the course of manual labor and ladies all over the world offer confinement in labor containers. Therefore, one of the benefits of the barrels that are precisely premeditated for deliveries is that they are moveable, animated and massive enough to provide lodgings association and have a diverse of labor stations.


According to the regulation on midwives, some significant modifications are taking place. For instance, the present tendency is to involve additional teaching and having an official documentation for the midwives, and to make them labor below unsure management of a medical doctor (Wilkinson, 2010). Therefore, this final condition restricts them typically to support at hospital births only. On the same note, the rules also may prevent equally the paternities and doctor from using the marginal of household birth. Moreover, such bylaws are likely to be set up in junior Federal Court beliefs from the initial part of the time (Wilkinson, 2010). However, most appear to accept that a hospital constructed, or at a minimum to any doctor who showed up during the birth process is the only suitable health optimal.

Quality of care

Many hospitals in numerous nations do echo and observe sign statistics with the purpose of civilizing the worth of maintenance (Wilkinson, 2010). Therefore, the superiority displays are usually aimed at sensing of the substituting of optimum attention either in building, procedure or result which can be used as an instrument to monitor the development of excellence advancement in fitness caution. Moreover, the intensive care of the wellbeing care of class creates the clinics to become more apparent for the doctors, sickbays, and patients. Additionally, it delivers evidence to object eminence upgrading creativities; on the other hand, the gathering of gauge facts also suggests a managerial problem for the surgeons and sanatoria and the use of this statistics should be enhanced.



Lindgren, H. E., Rådestad, I. J., Christensson, K., Wally-Bystrom, K., & Hildingsson, I. M. (2010). Perceptions of risk and risk management among 735 women who opted for a home birth. Midwifery, 26(2), 163-172.

Simpson, K. R. (2011). An overview of distribution of births in United States hospitals in 2008 with implications for small volume perinatal units in rural hospitals. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 40(4), 432-439.

Watterberg, K. L., Papile, L. A., Baley, J. E., Benitz, W., Cummings, J., Carlo, W. A., … & Tan, R. C. (2013). Planned home birth. Pediatrics, 131(5), 1016-1020.

Wax, J. R., Lucas, F. L., Lamont, M., Pinette, M. G., Cartin, A., & Blackstone, J. (2010). Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis. American journal of obstetrics and gynecology, 203(3), 243-e1.

Wilkinson, S. A., & Tolcher, D. (2010). Nutrition and maternal health: what women want and can we provide it?. Nutrition & Dietetics, 67(1), 18-25.

Yassaei, S., Mehrgerdy, Z., & Zareshahi, G. (2010). Prevalence of cleft lip and palate in births from 2003-2006 in Iran. Community dental health, 27(2), 118-121.


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