The online version of this article (doi:10.1186/s12884-017-1279-7) contains supplementary material, which is available to authorized users.
English maternity care policy has supported offering women choice of birth setting for over twenty years, but only 13% of women in England currently give birth in settings other than obstetric units (OUs). It is unclear why uptake of non-OU settings for birth remains relatively low. This paper presents a synthesis of qualitative evidence which explores influences on women’s experiences of birth place choice, preference and decision-making from the perspectives of women using maternity services.
Qualitative evidence synthesis of UK research published January 1992-March 2015, using a ‘best-fit’ framework approach. Searches were run in seven electronic data bases applying a comprehensive search strategy. Thematic framework analysis was used to synthesise extracted data from included studies.
Twenty-four papers drawing on twenty studies met the inclusion criteria. The synthesis identified support for the key framework themes. Women’s experiences of choosing or deciding where to give birth were influenced by whether they received information about available options and about the right to choose, women’s preferences for different services and their attributes, previous birth experiences, views of family, friends and health care professionals and women’s beliefs about risk and safety. The synthesis additionally identified that women’s access to choice of place of birth during the antenatal period varied. Planning to give birth in OU was straightforward, but although women considering birth in a setting other than hospital OU were sometimes well-supported, they also encountered obstacles and described needing to ‘counter the negativity’ surrounding home birth or birth in midwife-led settings.
Over the period covered by the review, it was straightforward for low risk women to opt for hospital birth in the UK. Accessing home birth was more complex and contested. The evidence on freestanding midwifery units (FMUs) is more limited, but suggests that women wanting to opt for an FMU birth experienced similar barriers. The extent to which women experienced similar problems accessing alongside midwifery units (AMUs) is unclear.
Women’s preferences for different birth options, particularly for ‘hospital’ vs non-hospital settings, are shaped by their pre-existing values, beliefs and experience, and not all women are open to all birth settings.
Additional file 1: Search strategy and structure and additional detail about selection. (DOCX 32 kb)12884_2017_1279_MOESM1_ESM.docx
Additional file 2: Table S1. CASP appraisals. Two reviewers (KC and AC) appraised included papers using the CASP qualitative checklist ( https://www.casp-uk.net/). The first reviewer (KC) conducted a full CASP appraisal, and a second reviewer (AC) independently conducted a modified CASP appraisal focusing on the adequacy of reporting, following Carroll et al.’s method [ 1]. The reviewers resolved areas of disagreement following initial reviews; these were minor and reflected variation in degree to which a paper met a given criteria, rather than conflicting views about the paper. No papers were excluded from the review on the basis of quality. (DOCX 41 kb)
Additional file 3: Examples of data and evidence to support a-priori themes (Tables A and B). (DOCX 50 kb)12884_2017_1279_MOESM3_ESM.docx
Department of Health. Changing Childbirth: Report of the Expert Maternity Group. London: HMSO; 1993.
National Institute of Clinical and Healthcare Excellence (NICE). Intrapartum care care of healthy women and their babies during childbirth. Clinical Guideline 190 NCCWCH London. 2014. https://www.nice.org.uk/guidance/cg190. Accessed 14 Feb 17.
Birthplace in England Collaborative Group. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ. 2011;116(9):1177–84. doi: 10.1136/bmj.d7400.
Hodnett ED, Downe S, Walsh D, Weston J. Alternative versus conventional institutional settings for birth (Review). Cochrane Database of Systematic Reviews (Issue 9). 2010. doi 10.1002/14651858.CD000012.pub3.
Schroeder E, Petrou S, Patel N, Hollowell J, Puddicombe D, Redshaw M, Brocklehurst P. Cost effectiveness of alternative planned places of birth in woman at low risk of complications: evidence from the Birthplace in England national prospective cohort study. Br. Med. J.2012. doi: 10.1136/bmj.e2292.
National Audit Office. Maternity Services in England. London: National Audit Office; 2013.
Barber T, Rogers J, Marsh S. Increasing out-of-hospital births: what needs to change? Br J Midwifery. 2007;15(1):16–20. CrossRef
Houghton G, Bedwell C, Forsey M, Baker L, Lavender T. Factors influencing choice in birth place -- an exploration of the views of women, their partners and professionals. Evid Based Midwifery. 2008;6(2):59–64.
Health Committee. (1992). Maternity Services, Session 1991/2 [known as “The Winterton Report”]. HMSO London.
Birthplace Choices Project. (n.d.). Retrieved October 31, 2016, from https://www.npeu.ox.ac.uk/research/birthplace-choices-304. Accessed 21 Mar 2017.
Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In Ritchie, J, & Spencer, L. London: Analysing Qualitative Data Routledge; 1994. pp. 173–194.
Brunton G, Oliver S, Oliver K, Lorenc T. A synthesis of research addressing children’s, young people’s and parents’ views of walking and cycling for transport. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London; 2006.
Khan AA, Bhardwaj SM. Access to health care. A conceptual framework and its relevance to health care planning. Eval Health Prof. 1994. doi: 10.1177/016327879401700104.
Methley AM, Campbell S, Chew-Graham C, Mcnally R, Cheraghi-Sohi S. PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014;14(579):1–10. doi: 10.1186/s12913-014-0579-0.
Critical Appraisal Skills Programme. (n.d.). Retrieved October 31, 2016, from http://media.wix.com/ugd/dded87_25658615020e427da194a325e7773d42.pdf. Accessed 21 Mar 2017.
NVivo Qualitative Data Analysis. (n.d.). Retrieved October 31, 2016, from http://www.qsrinternational.com/. Accessed 21 Mar 2017.
National Maternity Review. Better Births: improving outcomes of maternity services in England. A five year forward view for maternity care. London; 2016.
Hollowell J, Chisholm A, Li Y, Malouf R. A systematic review and narrative synthesis of the quantitative and qualitative literature on women’s birth place preferences and experiences of choosing their intended place of birth in the UK: Report 4. Oxford: National Perinatal Epidemiological Unit; 2015. https://www.england.nhs.uk/wp-content/uploads/2015/07/npeu-report4-choices-evidence-review-synthesis.pdf. Accessed 14 Feb 2017.
Mansion EM, McGuire MM. Professional issues. Factors which influence women in their choice of DOMINO care. Br J Midwifery. 1998;6(10):664–8. CrossRef
Jomeen J. Choice in childbirth: a realistic expectation ? Br J Midwifery. 2007;15(8):485–90. CrossRef
Shaw R, Kitzinger C. Calls to a home birth helpline: empowerment in childbirth. Soc Sci Med. 2005;61(11):2374–83. doi: 10.1016/j.socscimed.2005.04.029.
Andrews A. Home birth experience 1: decision and expectation. Br J Midwifery. 2004;12(8):518–23. CrossRef
Barber T, Rogers J, Marsh S. The birth place choices project: phase one. Br J Midwifery. 2006;14(10):609–13. CrossRef
Ogden J, Shaw A, Zander L. Women’s experience of having a hospital birth. Br J Midwifery. 1998;6(5):339–45. CrossRef
Lavender T, Chapple J. How women choose where to give birth. Practising Midwife. 2005;8(7):10–5. PubMed
Ogden J, Shaw A, Zander L. Women’s memories of homebirth. Part 3. A decision with a lasting effect. Br J Midwifery. 1997;5(4):216–8. CrossRef
Ogden J, Shaw A, Zander L. Women’s memories of homebirth. Part 2. Deciding on a homebirth: help and hindrances. Br J Midwifery. 1997;5(4):212–5. CrossRef
McCutcheon R, Brown D. A qualitative exploration of women’s experiences and reflections upon giving birth at home. Evid Based Midwifery. 2012;10(1):23–8.
Grigg C, Tracy SK, Daellenbach R, Kensington M, Schmied V. An exploration of influences on women’s birthplace decision-making in New Zealand: a mixed methods prospective cohort within the Evaluating Maternity Units study. BMC Pregnancy Childbirth. 2014;14(1):210. doi: 10.1186/1471-2393-14-210. CrossRefPubMedPubMedCentral
Redshaw M, Rowe R, Schroeder L, Puddicombe D, Macfarlane AJ, Newburn M, … Marlow N. Mapping maternity care. The configuration of maternity care in England. Birthplace in England research programme. Final report part 3. NIHR Service Delivery and Organisation, (November 2011). 2011.
- What influences birth place preferences, choices and decision-making amongst healthy women with straightforward pregnancies in the UK? A qualitative evidence synthesis using a ‘best fit’ framework approach
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