Fulop, NJ; (2015) How do pregnancy and birth experiences influence planned place of birth in future pregnancies? Findings from a longitudinal, narrative study. Birth , 42 (2) pp. 141-148. 10.1111/birt.12149.

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Abstract

A perception that first birth is more risky than subsequent births has led to women planning births in Obstetric Units, and care providers supporting these choices. This study explored the influence of pregnancy and birth experiences on women’s intended place of birth in current and subsequent pregnancies. Methods: Prospective, longitudinal narrative interviews (n=122) with forty-one women in three English NHS sites. During postnatal interviews, women reflected on their recent births and discussed where they might plan to give birth in a future pregnancy. Longitudinal narrative analysis methods were used to explore these data. Results: Women’s experience of care in their eventual place of birth had more influence upon decisions about the (hypothetical) next pregnancy than planned place of birth during pregnancy did. Women with complex pregnancies usually planned hospital Obstetric Unit (OU) births, but healthy women with straightforward pregnancies also chose OU and would often plan the same for the future, particularly if they experienced OU during recent births. Discussion: The experience of giving birth in a hospital OU reinforced the notion that birth is risky and uncertain, and that hospital OU is the best or safest setting for birth. The assumption that women will opt for lower acuity settings for second or subsequent births was not supported by these data, which may mean that multiparous women who best fit criteria for non-OU births are reluctant to plan births in these settings. This highlights the importance of providing balanced information about risks and benefits of different birth settings to all women during pregnancy.

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