Transfer from home to hospital: what is its effect on the experience of childbirth?

Abstract

In the Netherlands women with low-risk pregnancies are free to choose where to give birth, at home or in hospital, attended by an independent midwife or general practitioner. On average one of five women who remains in the care of a midwife at the onset of labor will be referred to an obstetrician during or shortly after childbirth. If women had planned to give birth at home, they would then have to be transferred to the hospital. Postal questionnaires were sent to 2301 pregnant women before and after birth to measure the experience of childbirth, appropriateness of the chosen place of birth, satisfaction with the birth, midwife's care, and first days postpartum of women planning to give birth at home or in hospital. The response rate for both questionnaires was 89.3 percent. Of 745 nulliparous women and 895 multiparous women, 39.3 and 10.3 percent, respectively, experienced referral to an obstetrician during labor. Of these women, the ones who wanted to give birth at home but were transferred to hospital because of the referral were as positive about the birth, early puerperium, and attendance of the midwife as the women who wanted to give birth in hospital. Our research showed, contrary to expectations, that an unplanned transfer from a planned home birth to hospital has little influence on the experience of childbirth.