Table 4 Summary of findings (Review 1)
Resource issues | Organisational and professional norms | Influence of midwifery colleagues | Midwives’ perspectives on their role in women’s decision-making | Confidence of midwives | Strategies for improvement |
|---|---|---|---|---|---|
• Lack of midwifery staff • Time pressures • Resource implications (unit closures) | • Hospital policies/organisational pressures • Peer opinion • Pressure to conform to status quo • Concerns about litigation | • Conflicting opinions about place of birth settings • Lack of homebirth promotion • Unsupportive attitudes towards homebirth | • Importance of offering range of choices • Booking visit wrong time for discussion • Women’s decision-making unaffected by discussion • Cultural/societal factors, and parity, influence women’s decision-making • Women’s responsibility to explore options • Importance of revisiting options with women | • Varying levels of confidence around discussing homebirth • Unwillingness and uncertainty of offering homebirth • Lack of skill and confidence in different birth settings | • Training in discussion of risk and promotion of homebirth • Leaflet focusing on birthplace choices for women |