Aim. To explore first-time pregnant women's expectations and factors influencing their choice of birthplace.Background. Although outcomes and advantages for low-risk childbearing women giving birth in midwifery-led units and home compared with obstetric units have been investigated previously, there is little information on the factors that influence women's choice of place of birth.
Design.A qualitative Straussian grounded theory methodology was adopted. Fourteen women expecting their first baby were recruited from three large National Health Service organisations that provided maternity services free at the point of care. The three organisations offered the following birthplace options: home, freestanding midwifery unit and obstetric unit. Ethical approvals were obtained and informed consent was gained from each participant.Methods. Data collection was undertaken in 2013-2014. One tape-recorded face-to-face semistructured interview was conducted with each woman in the third trimester of pregnancy.Findings. Findings are presented as three main themes: a) influencing factors on the choice of birthplace; b) expectations on the midwife's 'being' and 'doing' roles; c) perceptions of safety.
Conclusion. Midwives should consider each woman's expectations and approach to birthbeyond the planned birthplace, as these are often influenced by the intersection of various influencing factors. Several birthplace options should be made available to women in each maternity service and the alternatives should be shared with women by healthcare professionals during pregnancy to allow an informed choice. Virtual tours or visits to the birth units could also be offered to women to help them familiarise with the chosen setting.3 Keywords: midwifery; women's health; childbearing; choice; birthplace; place of birth; obstetric unit; homebirth; freestanding midwifery unit; pregnancy.
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SUMMARY STATEMENT
Why is this research needed? Although outcomes and advantages for women giving birth in different settings are demonstrated, there is little information on the factors that influence women's choice of birthplace. By understanding factors influencing women's choice of birthplace, healthcare professionals may be better able to facilitate informed choice; this is highlighted as a key factor in moving maternity provision forward.
What are the key findings? This paper contributes novel evidence on women's expectations around choice of birthplace, increasing understanding of the factors that are important to them when choosing a preferred birth setting, including proximity; normality of childbirth; environment; model of care; TV programmes; recommendations from family and friends. Participants specified that the midwife's role should include both spheres of 'being' and 'doing'. Some participants planning to give birth in an obstetric unit confined the midwife's role to 'doing checks'. Women's perceptions of birthplace safety varied, including having medical backup available in obstetric units, one-to-one dedicated midwifery care...