Agustsson P Risk discourse in the UK: an obstetric perspective. In: Symon A (ed). London: Churchill Livingstone; 2006

Barber T, Rogers J, Marsh S The Birth Place Choices Project: phase one. British Journal of Midwifery. 2006; 14:(10)609-13

Brocklehurst P, Hardy P, Hollowell J, Linsell L, Macfarlane A, McCourt C, Marlow N, Miller A, Newburn M, Petrou S 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; 343

Davis D Spoilt for choice: consuming maternity care. British Journal of Midwifery. 2003; 11:(9)574-8

Dodwell M Normal Birth rates in England. Perspective. 2012; 16:16-17

Emden C Conducting a narrative anlysis. Collegian. 1998; 5:(3)34-9

Finlay L, Gough BOxford: Wiley-Blackwell; 2003

Hodnett ED, Downe S, Walsh D, Weston J Alternative versus conventional institutional settings for birth. Cochrane Database Syst Rev. 2012; 8:(8)

Houghton G, Bedwood C, Forsey M, Baker L, Lavender T Factors influencing women's choice in birth place - an exploration of the views of women, their partner and professional. Evidence Based Midwifery. 2008; 6:(2)59-64

Johnston J The nesting instinct. Midwifery Today Int Midwife. 2004; 8:(71)36-7

Jomeen J Choice in childbirth: a realistic expectation?. British Journal of Midwifery. 2007; 15:(8)485-90

Kightley R Delivering choice: where to birth?. British Journal of Midwifery. 2007; 15:(8)475-8

Lieblich A, Tuval-Mashiach R, Zilber TThousand Oaks, CA: Sage Publications; 1998

MacKenzie Bryers H, van Teijlingen E Risk, theory, social and medical models: A critical analysis of the concept of risk in maternity care. Midwifery. 2010; 26:(5)488-96

Morris S Is fear at the heart of hard labour?. MIDIRS. 2005; 15:(4)508-11

Mottram M First-time expectant fathers and their influence on decision making regarding choice for place of birth. MIDIRS. 2008; 18:(4)582-9

Murray-Davis B, McNiven P, McDonald H, Malott A, Elarar L, Hutton E Why home birth? A qualitative study exploring women's decision making about place of birth in two Canadian provinces. Midwifery. 2012; 28:(5)576-81

National Institute for Health and Care Excellence. Intrapartum care for healthy women and babies. 2016. (accessed 17 January 2017)

National Maternity Review. 2016. (accessed 18 January 2016)

National Perinatal Epidemiology Unit. Informing policy on childbirth choices: the Birthplace Choices project. 2016. (accessed 18 January 2016)

Office for National Statistics. Birth characteristics in England and Wales: 2014. 3. Home births. 2015. (accessed 24 January 2017)

Pitchforth E, van Teijlingen E, Watson V, Tucker J, Kiger A, Ireland J, Farmer J, Rennie A-M, Gibb S, Thomson E Choice and place of delivery: a qualitative study of women in remote and rural Scotland. Qual Saf Health Care. 2009; 18:(1)42-8

Rogers C, Harman J, Selo-Ojeme D Perceptions of birth in a stand-alone centre compared to other options. British Journal of Midwifery. 2011; 19:(4)237-44

Savage JS Birth Stories: A Way of Knowing in Childbirth Education. J Perinat Educ. 2001; 10:(2)3-7

In: Symon A London: Churchill Livingstone; 2006

Walker DM The internet as a medium for health service research. Part 1. Nurse Res. 2013; 20:(4)18-21

Walsh D Risk and normality in maternity care: revisioning risk for normal childbirth. In: Symon A London: Churchill Livingstone; 2006

Walsh D, Devane D A metasynthesis of midwife- led care. Qual Health Res. 2012; 22:(7)897-910

Webster L, Mertova PAbingdon: Routledge; 2007

‘Where do you want to have your baby?’ Women's narratives of how they chose their birthplace

02 February 2017
Volume 25 · Issue 2



National guidelines endorse the provision of birthplace choice for women with low-risk pregnancies. Despite the availability of different options (birth centre, home and hospital) and substantial evidence highlighting the benefits of birth outside a hospital setting, the majority of women choose to give birth in a hospital.


This study aimed to: explore how low-risk, first-time mothers chose where to give birth to their babies; and gain an in-depth understanding of what factors influenced women's experiences of decision-making.


A qualitative study with a narrative approach was used. Data were collected using an online questionnaire. Participants were recruited from a social networking site. A purposive sample of nine low-risk, first-time mothers, all of whom were given a choice of birthplace (at least two options), was used.


Two core themes emerged that were considered to influence women's decisions on birthplace: women's expectations of birth, perception of safety and protecting the birthing process; and the influence of the midwife, antenatal education and the partner.


The study reveals that women make choices based on a variety of reasons. However, the findings presented suggest that most women give birth in a hospital as it is still widely considered to be the safest place for women and babies—both by couples themselves and by many health professionals. The challenge is to address this generation of women who believe that hospital is the most appropriate place to give birth, despite evidence to the contrary, and ultimately promote the normality of pregnancy and childbirth.

‘Where do you want to have your baby?’ Most women are faced with this question at their very first midwife appointment. So it is not surprising that ‘choice’ is one of the mantras of the modern age (Symon, 2006). This is particularly true of maternity care within the NHS, and is a key topic resonating throughout the recent publication of the National Maternity Review (2016).

Choice of birthplace for low-risk women is a central theme in current national guidelines and, depending on geographical location and availability, options include an obstetric-led hospital service, a midwife-led birth centre—which might be either stand-alone or alongside hospital services—and birth at home.

The benefits of providing midwife-led care, at home or in a midwife-led birth centre, are well documented (Brocklehurst et al, 2011; Hodnett et al, 2012). The Birthplace study (Brocklehurst et al, 2011) is a seminal research project that was undertaken to compare outcomes in birth settings offered by the NHS. The findings revealed that there was no significant difference in outcomes for perinatal mortality and intrapartum-related neonatal morbidities in any of the midwife-led care settings (home or birth centre) when compared with obstetric-led services. The study also indicated that there were substantially fewer interventions and significantly higher rates of normal birth in all midwife-led settings when compared to obstetric services (Brocklehurst et al, 2011). The authors concluded by endorsing current policies relating to birthplace choice, and emphasised the safety of midwife-led care outside of hospital settings and the associated benefits of such forms of care.

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