What influences women in Athens to choose home birth?

Abstract

Home birth rates in Greece have decreased in the last 25 years and make up less than 0.9% of the total births. In contrast, the caesarean section rate exceeded 50% in 2001. The home birth service is only provided on a small scale by private midwives and does not come under the auspices of the Greek National Health Service. It is argued that women should have a right to choose where to give birth, but it seems that this is not an option for most Greek women. In order to understand the reasons women in Athens give for choosing a home birth, narrative interviews were conducted. According to the findings, women in this study decided on a home birth primarily because they wanted to be in control of their birthing experience. The familiar surroundings of their home gave them a sense of reassurance and safety, which in turn enhanced their self esteem and confidence during labour. The belief that birth is a natural event the woman's body is programmed for was another reason women gave for choosing a home birth. This belief in normality of labour came in contrast to the strict medical atmosphere of hospitals'.

Concurrent analysis of choice and control in childbirth

“…Hospitals are construed by some [31,34] as unsafe. This is because they are for sick people and pregnancy is not an illness but a natural process [33].…”

“…For Kontoyannis and Katsetos [34] the knowledge underpinning decision making is provided unwittingly by the doctor's 'horror story' describing the routine episiotomy, shave and enema prior to a planned hospital birth. Consequently, the woman chooses home.…”

“…The broader literature is not so clear cut, and whilst perceptions that support the notion of childbirth as risky [ 10 ] and hospital as a place of safety [ 32 ] are evident, there is substantial evidence of the opposite perception. Hospitals are construed by some [ 31 , 34 ] as unsafe. This is because they are for sick people and pregnancy is not an illness but a natural process [ 33 ].…”

Prevalence of Compassion Fatigue, Burn-Out and Compassion Satisfaction Among Maternity and Gynecology Care Providers in Greece

“…Public Maternal Hospitals are sub-optimally staffed, low in recourses while proper and close monitoring of women in labour in one to one ratio is impossible and therefore many doctors resort to CSs (24). Nonetheless, the birth culture in Greece was highly medicalised even before the crisis since almost all births were performed in hospital settings in both the Greek National Health Service and the private health care system (25). Furthermore, there are no primary obstetric care settings or birth clinics in community.…”

Experiences of Greek women of water immersion during normal labour and birth. A qualitative study

“…This means that birth takes place within hospital environment settings in either secondary or tertiary general hospitals of the Greek State-funded National Health Service (NHS) or in tertiary private hospitals 5 . Unfortunately, there are no primary healthcare settings, no community midwives or midwifery-led birthing units in the current Greek (public or private) healthcare system, and home births represent less than 0.9% of total births 5 . Maternity care in the Greek NHS is free to all women and it covers all costs for antenatal care, childbirth and postnatal care.…”