Perceptions of birth in a stand-alone centre compared to other options

Abstract

Promoting choice is central to current NHS policy. In seeking to better understand the choices women make, this study aimed to identify if women would choose to give birth in a stand-alone birth centre, and the factors influencing this choice. A survey approach was adopted, and 121 responses were obtained (a response rate of 53%). The majority (n = 76, 62.8%) of responders would choose to have their baby in a stand-alone birth centre. The provision of a homely environment, opportunities for a natural birth, use of water in labour and accessibility were the main reasons given for choosing to give birth at a specific stand-alone birth centre. Compared to second or subsequent births, women expecting their first baby were six times more likely to give ‘can use water in labour and birth’ as a reason and this was significant (P = 0.001). Among women who would not choose to deliver in a stand-alone birth centre, the main reasons were preference to give birth in a co-located unit and concerns over safety. There was no significant difference about concerns for transfer between primagravid women and multigravid women. Nevertheless, in contrast to previous studies, 87% of women perceived that birth in a stand-alone birth centre provided a safe alternative to a hospital birth or home birth. Women also stated that they would access a stand-alone birth centre for pregnancy testing, antenatal education and antenatal and postnatal care.

Women’s birth place preferences in the United Kingdom: a systematic review and narrative synthesis of the quantitative literature

“… February to March 1996 Study focuses on service attributes preferred antenatally vs. postnatally. Rogers (2011) [ 24 ] This study was conducted to evaluate the viability of converting an AMU in outer London to an FMU following the planned closure of the OU in the hospital. The study focused on whether users of the existing AMU would choose the new FMU or would look for an alternative.…”

“…Five studies used discrete choice or other experimental stated preference methods [ 15 , 16 , 18 – 20 ]; five asked women to rate the aspects of maternity services that were important to them [ 15 , 16 , 21 – 23 ]. One study reported women’s reasons for choosing a specific unit or setting [ 24 ]; and one study asked women to state what factors had affected their booking decision [ 21 ].…”

“…Two studies were conducted in London [ 18 , 24 ]. In one of these, the evaluation was conducted in an area that was considering shutting its OU and converting the local AMU to an FMU [ 24 ] and the study was designed to evaluate whether current AMU users would consider birth in the unit if it became an FMU.…”

“…Two studies were conducted in London [ 18 , 24 ]. In one of these, the evaluation was conducted in an area that was considering shutting its OU and converting the local AMU to an FMU [ 24 ] and the study was designed to evaluate whether current AMU users would consider birth in the unit if it became an FMU. The other was a stated preference study conducted in areas with high home birth rates, comparing preferences in women booked for a home birth with ‘low risk’ women booked for a hospital birth [ 18 ].…”

Choosing a Model of Maternity Care: Decision Support Needs of Australian Women

“…A third group of studies has explored the importance women place on a diverse range of attributes (or having information about a diverse range of attributes ) when choosing a particular birth setting. These studies represent those most useful for inferring women's information priorities and broadly suggest that women value information about qualities of the birth environment (e.g., homeliness) , support for patient autonomy or involvement in decisions , availability of specialty services in the event of complications , access to specific birthing options or provider support , and other women's recommendations of the birth setting . Notwithstanding, these studies have focused on attributes that tend to vary between birth settings of a similar type, which means they either did not assess the importance of attributes that are universal across settings but vary between models of care (such as the birth setting itself), or attributes that may vary across different models of care available at a particular type of birth setting (such as choice of provider and continuity of care).…”