‘I didn’t think you were allowed that, they didn’t mention that.’ A qualitative study exploring women’s perceptions of home birth

Jo Naylor Smith, Beck Taylor, Karen Shaw, Alistair Hewison, Sara Kenyon

Evidence suggests that home birth is as safe as hospital birth for low risk multiparous women, and is associated with reduced intervention rates and increased rates of normal birth. However the home birth rate in the UK is low, and few women choose this option. The aims of this study were to identify what influences multiparous women's choice of birth place, and to explore their views of home birth. Five focus groups were conducted with multiparous women (n = 28) attending mother and baby groups in a city in the UK with a diverse multi-ethnic population. Data were analysed thematically using the Framework Method, combining deductive and inductive approaches to the data. Several themes were developed from the data, these were: the expectation that birth would take place in an Obstetric Unit; perceptions of birth as a 'natural' event; lack of knowledge of what home birth looked like; and a lack of confidence in the reliability of the maternity service. Two themes emerged regarding the influences on women's choices: clear information provision, particularly for those from ethnic minority groups, and the role of health care professionals. A final theme concerned women's responses to the offer of choice. There are gaps in women's knowledge about the reality and practicalities of giving birth at home that have not been previously identified. Other findings are consistent with existing evidence, suggesting that many women still do not receive consistent, comprehensive information about home birth. The findings from this research can be used to develop approaches to meet women's information and support needs, and facilitate genuine choice of place of birth.