The influences on women who choose publicly-funded home birth in Australia

Objective: to explore the influences on women who chose a publicly-funded home birth in one Australian state. Design: a constructivist grounded theory methodology was used. Setting: a publicly-funded home birth service located within a tertiary referral hospital in the southern suburbs of Sydney, Australia. Participants: data were collected though semi-structured interviews of 17 women who chose to have a publicly-funded home birth. Findings: six main categories emerged from the data. These were feeling independent, strong and confident, doing it my way, protection from hospital related activities, having a safety net, selective listening and telling, and engaging support. The core category was having faith in normal. This linked all the categories and was an overriding attitude towards themselves as women and the process of childbirth. The basic social process was validating the decision to have a home birth. Conclusion: women reported similar influences to other studies when choosing home birth. However, the women in this study were reassured by the publicly-funded system's 'safety net' and apparent seamless links with the hospital system. The flexibility of the service to permit women to change their minds to give birth in hospital, and essentially choose their birthplace at any time during pregnancy or labour was also appreciated. Implications for practice: women that choose a publicly-funded home birth service describe strong influences that led them to home birth within this model of care. Service managers and health professionals need to acknowledge the importance of place of birth choice for women.