Community midwives' views and experience of home birth.

This two-part study explored the home birth experiences of all full time practising community midwives within three health authorities. The study consisted of a self-completion questionnaire, followed by interviews with a random stratified sub-sample of the midwives. The study sample consisted of 56 midwives of whom 44 (78%) agreed to participate. The total experience of home birth by these midwives was limited. The mean number of home births undertaken in the previous year was only two and 14 midwives had not undertaken any. The average number of home births undertaken in their whole career was six. Four midwives (9%) had never undertaken any. Only two midwives (5%) routinely offered home birth at booking. Despite lack of experience, half the sample were strongly positive about home birth. Factors that influenced their feelings about home birth were more complex but were unrelated to the amount of their home birth experience, their age, training or own experience of childbirth. Positive feelings about home birth resulted from the quality of positive previous experiences, education and knowledge and an autonomous view of women and midwives. Negative feelings tended to result from a lack of specific skills, namely suturing, resuscitation and siting of IVIs, midwives' inadequate support networks, doctors' attitudes and a confused perception of the provision of emergency cover.