First-time mothers’ choice of birthplace: influencing factors, expectations of the midwife's role and perceived safety

Borrelli, Sara E.; Walsh, Denis; Spiby, Helen

Abstract

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 organizations that provided maternity services free at the point of care. The three organizations 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: (i) influencing factors on the choice of birthplace; (ii) expectations on the midwife's ‘being’ and ‘doing’ roles; (iii) perceptions of safety.

Conclusion

Midwives should consider each woman's expectations and approach to birth beyond 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 familiarize with the chosen setting.

Citation

Borrelli, S. E., Walsh, D., & Spiby, H. (2017). First-time mothers’ choice of birthplace: influencing factors, expectations of the midwife's role and perceived safety. Journal of Advanced Nursing, 73(8), 1937-1946. https://doi.org/10.1111/jan.13272

• Journal Article Type: Article
• Acceptance Date: Jan 30, 2017
• Online Publication Date: Mar 2, 2017
• Publication Date: 2017-08
• Deposit Date: Mar 2, 2018
• Publicly Available Date: Mar 2, 2018
• Journal: Journal of Advanced Nursing
• Print ISSN: 0309-2402
• Electronic ISSN: 1365-2648
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 73
• Issue: 8
• Pages: 1937-1946
• DOI: https://doi.org/10.1111/jan.13272
• Keywords: Birthplace; Childbearing; Choice; Freestanding midwifery unit; Homebirth; Midwifery; Obstetric unit; Place of birth; Pregnancy; Women’s health
• Public URL: https://nottingham-repository.worktribe.com/output/872058
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1111/jan.13272/abstract
• Additional Information: This is the peer reviewed version of the following article: Borrelli S.E., Walsh D. & Spiby H. (2017) First-time mothers’ choice of birthplace: influencing factors, expectations of the midwife's role and perceived safety. Journal of Advanced Nursing 73(8), 1937–1946. doi: 10.1111/jan.13272., which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/jan.13272/abstract. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
• Contract Date: Mar 2, 2018