Factors which influence women in their choice of DOMINO care

Abstract

This exploratory qualitative study of what influences women in their choice of DOMINO (Domiciliary in and out) care attempted to identify why this system of maternity care had a particularly low uptake in central Scotland. Although not established for this purpose 30 years ago, DOMINO care theoretically provides choice, control and continuity, yet only 1–2% of all women in Scotland deliver within this system of care. The strongest themes to emerge from the interviews were previous negative birth experience, initial requests for home birth and the individualized care the women anticipated from their community midwives. The benefits of DOMINO care for these women can be encompassed in the term ‘Individualism’ and the trust and friendship invested in their community midwife was the vehicle to this objective. Despite the small sample, these findings raise many pertinent issues applicable to the provision of this and other systems of continuity of care.