Multiparous women's confidence to have a publicly-funded homebirth: A qualitative study

Abstract

Background: Hospital birth is commonly thought to be a safer option than homebirth, despite many studies showing similar rates of safety for low risk mothers and babies. Recently in Australia, demand has led to the introduction of a small number of publicly-funded homebirth programs. These offer homebirth to selected women who previously would not have considered this option. Women's confidence in having a homebirth through a publicly-funded homebirth program in Australia has not yet been explored. Aim: The aim of the study was to explore the reasons why women feel confident to have a homebirth within a publicly-funded model of care in Australia. Methods: Ten multiparous English-speaking women who chose to have a homebirth with the St George Hospital Homebirth Program were interviewed using semistructured, open-ended questions. A thematic analysis of transcriptions was undertaken. Data were part of a wider set collected as part of a doctoral study. Results: Women demonstrated a strong confidence in their ability to give birth at home and described a confidence in their bodies, their midwives, and the health system. Women weighed up the risks of homebirth through information they gathered and integration with their previous experience of birth, their family support and selfconfidence. Discussion: The publicly-funded hospital homebirth program strengthened the confidence of women to choose this model of care. Conclusion: Women choosing publicly-funded homebirth display strong confidence in both themselves to give birth at home, and their belief in the health system's ability to cope with any complications that may arise.

Decision-making regarding place of birth in high-risk pregnancy: a qualitative study

“…This study confirms earlier work on women's perceptions of childbirth: Catling-Paul et al (2011) found women who choose homebirths were more likely to display confidence in the natural birth process and perceive less need for potential medical intervention [20].…”

“…They are aware their choices will not be without an element of risk and employ practical and emotional coping strategies to manage these [21]. In discussions about place of birth, women prefer to focus on, and use language which reflects, concepts of safety rather than risk [20]. This study establishes women with high risk pregnancies also make decisions regarding place of birth with safety as their primary consideration.…”

“…Previous work on women's risk perception regarding place of birth has found women do want information about risks [20] and are aware of the risks associated with their birth choices [21]. Women will not take what they perceive as unnecessary or reckless risks with their own or their babies' health, rather they make choices they believe to be in their best interests [22].…”

Choosing homebirth – The women's perspective

“…9,14 The home birth has been described as an extremely positive, significant and empowering experience. 9,12,15,16 Redundancy of pain relief, increased self-confidence, the participation of the whole family and achieving autonomy are all associated with home birth. 9,10,17 Information about the safety of home birth is contradictory.…”

A provoking choice—Swedish women's experiences of reactions to their plans to give birth at home

“…They weighed the risks of home birth through information they had gathered and integrated with their experience of previous births, family support, and self-confidence. 13,14 Women who planned for a home birth tended to be more satisfied with the childbirth experience than those who planned to give birth in hospital, 15 they experienced less pain and required less pain relief. 16 No studies were found that addressed the reactions that woman face when choosing a home birth.…”