Original Survey Research
In the winter of 2015 I conducted an online survey of 1,057 women regarding their experiences, attitudes, and beliefs regarding nonhospital births. These women were recruited via Facebook, including in groups that targeted women interested in the topic of natural birth. Ages ranged from 19 to 71, with a mean age of 34 years old. At least 447 nonhospital births were planned. At least 1,456 births to the participants occurred in a hospital setting. Any uncounted births are due to participants selecting the “four or more” options for each category. 56 of the planned nonhospital births transported to the hospital during labor and are counted in both groups.
Of the participants who had hospital births, the most popular reasons for choosing the hospital included feeling like it was the safest place for the mom and baby, the fact that it was covered by insurance, and a desire for access to medical interventions. Among participants who chose nonhospital birth, the top reasons included a desire to avoid interventions, wanting more comfortable surroundings, a belief that birth does not require hospitalization, and the feeling that nonhospital birth was the safest choice.
53% of women who chose nonhospital birth indicated that they had consulted scientific journals when making their decision, compared with only 33% of hospital birthers. The women who chose nonhospital consulted most with a midwife, followed closely by their spouse or partner. The women who chose hospital birth consulted most with their spouse or partner, followed by a doctor.
I found that 87% of women who planned nonhospital birth agreed with the statement, “Generally speaking, giving birth in a non-hospital setting is at least as safe as giving birth in a hospital for low-risk women” (69% strongly agreed). One might suppose that experiencing complications at a nonhospital birth might change women’s perspectives, but I did not find this to be the case. I isolated the 74 women who had experienced transport (i.e., they or their baby were taken to the hospital during labor or shortly after birth) into a subgroup and found that 81% agreed with the “at least as safe” statement (and 64% strongly agreed). By contrast, only 43% of women who had never planned a nonhospital birth agreed that nonhospital birth was “at least as safe.”
When asked about the statement, “Having a safe and healthy mother and baby are the only things that truly matter in birth,” 68% of the women who had only had hospital births agreed with this statement. Of the women who planned nonhospital birth, only 36% agreed with this statement, and 50% disagreed (remainder neutral).
Women who choose nonhospital birth are overwhelmingly satisfied with their experience. Of the women who planned a nonhospital birth, 78.7% reported being “Very Satisfied” with their first nonhospital birth experience, increasing to 87.9% at the second nonhospital birth. By contrast, only 38.8% of the participants were “very satisfied” with their first hospital birth experience. In addition, women who plan a nonhospital birth are highly likely to recommend nonhospital birth to other women, with 59% reporting they would “definitely” recommend it and an additional 20% reporting they would “probably” recommend nonhospital birth.