Can women choose where to give birth? New research reveals how perceptions of risk influence decisions

Coxon and her colleagues conducted a series of narrative interviews with 41 participants throughout pregnancy rather than retrospective accounts used in previous studies. Their research found that birth was often seen as medically risky or subject to danger and as a result even healthy women with ‘low-risk’ pregnancies often consider hospital OUs as the safe choice. The reasons for this were varied and included fear of something going wrong, family history or advice, or practices in other European countries. The risks posed by hospital interventions were rarely mentioned by those planning hospital births with these interventions seen as life-saving rather than risky.

For those choosing home-births or FMUs the risks posed by hospital births was a factor in the decision making process along with a desire for a private environment, having known carers present, more ‘control’ during labour, and alternatives to pharmaceutical pain relief. However the researchers found that very few women, even when opting for non-OU births, actively took issue with the idea that birth was potentially risky or argued that birth without medical oversight was safer.

This research shows that perceptions of risk play a key role in pregnancy which is supported by the other articles in the special issue of Health, Risk & Society on ‘Risk, Pregnancy and Childbirth’. Research by Mandie Scamell and Mary Steward examines how midwives managing births in UK hospital settings accept the dominant medical risk-based approach that is embedding in a standardised timetable of labour monitoring using intrusive internal examinations. In another article looking at Canadian research, Camille Stengel shows risk impacts on pregnancy for women with a history of drug use who are subject to stigma and extra surveillance during pregnancy. Her research found that this can lead to these women delaying accessing maternal health and care services which can be ultimately worse for the well-being of both mother and child.

The special issue of Health, Risk & Society on ‘Risk, Pregnancy and Childbirth’ is edited by general editor Andy Alaszewski, Emeritus Professor University of Kent, and specialist guest editors, Kirstie Coxon, King’s College London, and Mandie Scamell, City University London.