Factors influencing women's choice of birth location

Abstract

This study was an attempt to examine retrospectively how women's attitudes about pregnancy, labour and birth affected their choice of birth location. Forty eight home birth and 82 hospital birth women in the Wellington District who had given birth in the last two years particpated in the study by completing a birth questionnaire. Five factors were examined which related to birth, namely: risk, intervention, confidence of women to care for their babies, knowledge about the birth process and birth anxiety. Two personality factors, locus of control and generalized anxiety, were also considered along with the effects of parity. Results for the full sample of home and hospital birth women showed that there was a significant multivariate difference between groups with factors of risk, intervention, confidence and birth anxiety contributing to this difference. Hospital birth women perceived more risk attached to birth, they were more likely to have intervention, they felt less confident about handling their babies after birth and they experienced more birth anxiety. Risk was the only predictor for birth location choice. The pattern of results for primiparous women when considered separately was similar to the full sample, except there was no difference between home and hospital birth women on the birth anxiety factor. Factors of risk, locus of control, knowledge, birth anxiety and confidence combined together to separate primiparous women and were the best predictors for birth location choice. Parous women also showed a significant difference between groups with a pattern of results similar to the full sample. Unlike the results for primiparous women however, only risk and locus of control factors were important in separating the groups and were the best predictors for birth location choice. Home birth women perceived the birth experience to be more satisfying. Because responses of primiparous and parous women differed, these findings suggest that more specific information about parity will help in understanding differences between home and hospital birth women and avoid difficulties of interpretation. With risk the most important factor, other implications of this study relate to hospital birth women needing further preparation to help reduce their perception of risk. While birth location choice should be decided by the women concerned, a desired outcome would be for hospital birth women to experience increased satisfaction.