Why do women choose homebirth in Australia? A national survey.

BACKGROUND

In Australia there have been regulatory and insurance changes negatively affecting homebirth.

AIM

The aim of this study is to explore the characteristics, needs and experiences of women choosing to have a homebirth in Australia.

METHODS

A national survey was conducted and promoted through social media networks to women who have planned a homebirth in Australia. Data were analysed to generate descriptive statistics.

FINDINGS

1681 surveys were analysed. The majority of women indicated a preference to give birth at home with a registered midwife. However, if a midwife was not available, half of the respondents indicated they would give birth without a registered midwife (freebirth) or find an unregistered birthworker. A further 30% said they would plan a hospital or birth centre birth. In choosing homebirth, women disclosed that they wanted to avoid specific medical interventions and the medicalised hospital environment. Nearly 60% of women reported at least one risk factor that would have excluded them from a publicly funded homebirth programme. Many women described their previous hospital experience as traumatic (32%) and in some cases, leading to a diagnosis of post-traumatic stress disorder (PTSD, 6%). Only 5% of women who reported on their homebirth experience considered it to be traumatic (PTSD, 1%). The majority of these were associated with how they were treated when transferred to hospital in labour.

CONCLUSION

There is an urgent need to expand homebirth options in Australia and humanise mainstream maternity care. A potential rise in freebirth may be the consequences of inaction.