How women with high risk pregnancies perceive interactions with healthcare professionals when discussing place of birth: A qualitative study

Objectives: to investigate women's perceptions of interactions with obstetricians and midwives during high risk pregnancies. The intention was to examine differences and similarities between women planning to give birth at home or in hospital.

Design: qualitative study using semi-structured interviews. Setting Maternity department in a hospital in South East England.

Participants: twenty-six women with high risk pregnancies, at least 32 weeks pregnant. Half were planning hospital births and half homebirths.

Measurements and findings: semi-structured interviews to investigate women's perception of communication. Results were analysed using thematic analysis. Four themes emerged: women's experiences of communication about risks in pregnancy; women's perceptions of professionals' beliefs about birth; women's trust in professionals; and women's attitude to professionals' advice. Women spoke more positively about communication with midwives than with obstetricians. Women planning hospital births expressed trust in obstetricians. Women planning homebirths expressed more trust in midwives. Women planning hospital births were less likely to question advice from professionals. Women planning homebirths were more inclined to trust their own instincts when these contradicted professional advice.

Key conclusions: women prefer to communicate with professionals who are respectful of their thoughts and feelings. They may not follow all professional advice.

Implications for practice: professionals working with women with high risk pregnancies should acknowledge women's concerns and deliver impartial, evidence-based advice.