Deciding on home or hospital birth: Results of the Ontario choice of birthplace survey

Murray‐Davis, Beth; McDonald, Helen; Rietsma, Angela; Coubrough, Melissa; Hutton, Eileen K.

doi:10.1016/j.midw.2014.01.008

Cited by 52 publications

(42 citation statements)

References 12 publications

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“…Therefore, this discrepancy in findings might well be due to our larger sample size. Our findings correspond with recent research showing that women in midwife-led care who decide to plan a hospital birth or who have difficulty in choosing their place of birth, determine their choice largely on their perceptions of risk and safety [37]. Risk perception during pregnancy, a factor shown to affect the choice regarding place of birth [34–39], might explain the associations found in our study between pregnancy related anxiety and general anxious or depressed mood with planned place of birth in hospital.…”

Section: Discussionsupporting

confidence: 90%

“…Indeed, several studies have recently shown that motivational factors relating to risk-perception and safety seem critical in the choice of low risk women to plan hospital instead of home birth [35–37]. Recently, perceptions of safety and risk were found to be the strongest determinants for choosing hospital birth in a cohort of low risk Canadian women [37].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, perceptions of safety and risk were found to be the strongest determinants for choosing hospital birth in a cohort of low risk Canadian women [37]. Psychological factors, especially pregnancy related anxiety, have been found to be important predictors of pregnancy risk perception [38, 39].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pregnancy related anxiety and general anxious or depressed mood and the choice for birth setting: a secondary data-analysis of the DELIVER study

Witteveen

Cock

Huizink

et al. 2016

BMC Pregnancy Childbirth

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BackgroundIn several developed countries women with a low risk of complications during pregnancy and childbirth can make choices regarding place of birth. In the Netherlands, these women receive midwife-led care and can choose between a home or hospital birth. The declining rate of midwife-led home births alongside the recent debate on safety of home births in the Netherlands, however, suggest an association of choice of birth place with psychological factors related to safety and risk perception. In this study associations of pregnancy related anxiety and general anxious or depressed mood with (changes in) planned place of birth were explored in low risk women in midwife-led care until the start of labour.MethodsData (n = 2854 low risk women in midwife-led care at the onset of labour) were selected from the prospective multicenter DELIVER study. Women completed the Pregnancy Related Anxiety Questionnaire-Revised (PRAQ-R) to assess pregnancy related anxiety and the EuroQol-6D (EQ-6D) for an anxious and/or depressed mood.ResultsA high PRAQ-R score was associated with planned hospital birth in nulliparous (aOR 1.92; 95% CI 1.32–2.81) and parous women (aOR 2.08; 95% CI 1.55–2.80). An anxious or depressed mood was associated with planned hospital birth (aOR 1.58; 95% CI 1.20–2.08) and with being undecided (aOR 1.99; 95% CI 1.23–2.99) in parous women only. The majority of women did not change their planned place of birth. Changing from an initially planned home birth to a hospital birth later in pregnancy was, however, associated with becoming anxious or depressed after 35 weeks gestation in nulliparous women (aOR 4.17; 95% CI 1.35–12.89) and with pregnancy related anxiety at 20 weeks gestation in parous women (aOR 3.91; 95% CI 1.32–11.61).ConclusionLow risk women who planned hospital birth (or who were undecided) more often reported pregnancy related anxiety or an anxious or depressed mood. Women who changed from home to hospital birth during pregnancy more often reported pregnancy related anxiety or an anxious or depressed mood in late pregnancy. Anxiety should be adequately addressed in the process of informed decision-making regarding planned place of birth in low risk women.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pregnancy related anxiety and general anxious or depressed mood and the choice for birth setting: a secondary data-analysis of the DELIVER study

Witteveen

Cock

Huizink

et al. 2016

BMC Pregnancy Childbirth

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show abstract

“…Women who choose out-of-hospital birth have different values and goals for their delivery (e.g., control over surroundings and a nonmedicalized experience without unnecessary interventions) than do women who choose hospital birth (e.g., the availability of pain relief and access to emergency services). 22 Third, although Oregon has a high out-of-hospital birth rate, the annual number of births in the state is relatively small (approximately 45,000, before exclusions), which provides low power for the analysis of rare outcomes. Our study was underpowered to analyze specific outcomes according to provider type, making this a useful area for future research.…”

Section: Discussionmentioning

confidence: 99%

Planned Out-of-Hospital Birth and Birth Outcomes

Snowden

Tilden

Snyder

et al. 2016

Obstetrical &Amp; Gynecological Survey

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“…Women tend to be fairly decisive regarding birthplace and most decide before pregnancy, by booking visit24 or within the first trimester 25. It seems unlikely that women will be more indecisive following use of a DST.…”

Section: The Intervention – the Mybirthplace Appmentioning

confidence: 99%

The effect of a birthplace decision support tool on women’s decision-making and information gathering behaviours during pregnancy: mybirthplace study protocol

Wiggins

2018

BMJ Health Care Inform

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The recent Maternity Review for England highlighted the need for more choice for women with more accessible information to support decisions. This study assesses the effect of an unique Decision Support Tool (DST) called MyBirthplace on decision making and information gathering behaviours of pregnant women regarding birth place choice. The study seeks to understand women's views and opinions about using the DST and their feelings about how well the DST supports them to make a decision. METHODS: A mixed method sequential exploratory design will be utilised to meet the above aim. This three phase study will involve a proposed sample of 169 women from a large maternity hospital in the United Kingdom. Phase one will be a questionnaire survey with women pre and post access to the DST, which is given to them by their midwife at the initial appointment. The questionnaire will look at baseline data, knowledge level and decision making using the Stages of Decision making scale (SDMS). A follow up questionnaire at 28 weeks (phase 2) will review the SDMS to enable the usefulness of Mybirthplace to be evaluated and to seek women's opinion on various aspects of MyBirthplace. The proposed sample size was determined by a power calculation based on changes attributed to the DST as measured by the SDMS. Phase three involves qualitative interviews with a minimum of 10 purposely chosen women at approximately 36 weeks gestation, and is followed by collating data on where the women actually give birth. DISCUSSION: This study is the first study to assess the effect of a DST in supporting women's choice of place of birth. It will add to current DST literature. It is also one of very few studies to utilise the stages of decision making scale with DST in pregnancy and thus will build on the existing literature; whilst broaching key concepts highlighted in the National Maternity Review.

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Deciding on home or hospital birth: Results of the Ontario choice of birthplace survey

Cited by 52 publications

References 12 publications

Pregnancy related anxiety and general anxious or depressed mood and the choice for birth setting: a secondary data-analysis of the DELIVER study

Pregnancy related anxiety and general anxious or depressed mood and the choice for birth setting: a secondary data-analysis of the DELIVER study

Planned Out-of-Hospital Birth and Birth Outcomes

The effect of a birthplace decision support tool on women’s decision-making and information gathering behaviours during pregnancy: mybirthplace study protocol

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