Informing policy on childbirth choices: the Birthplace Choices project

Summary

Current clinical guidelines and national policy in England support offering ‘low risk’ women a choice of birth setting, but despite an increase in provision of midwifery units in England the vast majority of women still give birth in obstetric units

The aim of the Birthplace Choices project is to generate evidence that can inform decisions about the commissioning and delivery of maternity services that support choice.

The first phase of the project has three components:

• A systematic review and narrative synthesis of the quantiative literature on women’s birth place preferences in the UK.
• A systematic review and synthesis of the qualitative literature on women’s birth place decision-making and preferences and the factors that facilitate or hinder choice.
• Qualitative research involving focus groups with pregnant women to explore the attributes of maternity services that influence ‘low risk’ women’s preferences and decisions about birth place, and identify factors that facilitate or hinder access to their preferred birth setting.

Phase 2 of the project (commencing January 2017) will involve a discrete-choice experiment to explore preferences and preference heterogeneity of place of birth. The aims of the study are:

• To extend our understanding of women's relative preferences for attributes associated with different birth settings.
• To determine whether there are subgroups of women with distinct patterns of prefereces, estimate the relative size of these subgroups and to explore the extent to which these subgroups map onto available birth settings.

Publications

Journal Articles

• Hollowell J, Li Y, Malouf R, Buchanan J. Women?s birth place preferences in the United Kingdom: a systematic review and narrative synthesis of the quantitative literature. BMC Pregnancy Childbirth. [journal article]. 2016;16:213.
• Coxon K, Chisholm A, Malouf R, Rowe R, Hollowell J. What influences birth place preferences, choices and decision-making amongst healthy women with straightforward pregnancies in the UK? A qualitative evidence synthesis using a ?best fit? framework approach. BMC Pregnancy Childbirth. [journal article]. 2017;17(1):103.
• Hinton L, Dumelow C, Rowe R, Hollowell J. Birthplace choices: what are the information needs of women when choosing where to give birth in England? A qualitative study using online and face to face focus groups. BMC Pregnancy Childbirth. [journal article]. 2018;18(1):12.

Reports

• Hollowell J, Chisholm A, Li Y, Malouf R. Evidence Review to Support the National Maternity Review 2015; Report 4: A systematic review and narrative synthesis of the quantitative and qualitative literature on women?s birth place preferences and experiences of choosing their intended place of birth in the UK. Oxford: National Perinatal Epidemiology Unit, University of Oxford. 2015.