Why home birth? A qualitative study exploring women's decision making about place of birth in two Canadian provinces

OBJECTIVE: the aim of this study was to increase our understanding of why Canadian women choose to give birth at home. Despite on-going debate regarding the safety of home birth, a small number of Canadian women choose home as a place to give birth. The factors influencing a woman's decision to plan a home birth remain poorly understood. DESIGN: a qualitative, grounded theory approach using semi-structured interviews. PARTICIPANTS: a purposive sample of women from two Canadian provinces, who planned to give birth at home in their current pregnancy or who had planned a home birth within the last 2 years. FINDINGS: thematic analysis highlighted key motivating factors as well as a decision-making framework by which women chose home birth. The decision making process includes an exploration of internal motivators for wanting home birth, a phase of information gathering and taking ownership for the decision to give birth at home. KEY CONCLUSIONS: the study showed that women in two geographically distinct parts of Canada approach decision making around home birth in a similar fashion and provides a framework for decision making for choosing to birth at home. IMPLICATIONS FOR PRACTICE: improved understanding of the decision making process for choice of birth place is useful for midwives for the provision of information to their clients and for midwifery policy and practice within Canada.