A comparison of labour and birth experiences of women delivering in a birthing centre and at home in the Netherlands

Abstract

Objective: to compare the labour and birth experiences of women who delivered at home without complications with the experiences of women who delivered in a birth centre without complications. Design: a descriptive study using postal questionnaires at 1-6 months after birth of a consecutive sample of postpartum women. Setting: women were recruited from one birth centre and three midwifery practices in an urban area of the Netherlands between September and December 2003. Participants: 193 women; 129 delivered at home and 64 delivered in the birth centre. Findings: the home-birth group perceived less pain (mean score home birth 6.291, birth-centre birth 6.977), desired less pain-relieving medication (home birth 7.9%, birth-centre birth 21.9%), believed they knew their midwife better (home birth 36%, birth-centre birth 10% 'knew her well'), and rated their birth setting 'higher' than the birth-centre group (mean score home birth 4.70, birth-centre birth 4.01). Furthermore, the birth-centre group emphasised safety, having medical help available, and convenience, whereas the home-birth group placed more importance on the home being trustworthy and dependable, having their own place and belongings, and feeling comfortable and relaxed. Key conclusions: having an understanding of a woman's labour and delivery experience allows health-care providers to continue to improve the quality of maternity care. The environment can have a positive effect on a woman's birth experience; recommendations have been proposed that can be applied to all pregnant and labouring women. Implications for practice: identification and understanding of the factors in the environment that make the labour and birth experience more positive should be incorporated into the education and preparation for an upcoming birth. © 2006 Elsevier Ltd. All rights reserved.