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Table 3 Summary of main findings

From: Women’s birth place preferences in the United Kingdom: a systematic review and narrative synthesis of the quantitative literature

Attribute of care

Women’s birth place preferences

Pain relief

Women attach considerable importance to the availability of pain relief options. Some wish to have access to an epidural if needed, without necessarily intending to have one.

Pain relief preferences appear to be influenced by women’s expectations of the options available to them.

Medical staff involvement/availability

A substantial proportion of women have a strong preference for care in a hospital setting where medical staff are not necessarily involved in their care, but are readily available.

Ethnic minority women may be more likely to prefer a hospital birth and to have a range of medical facilities available on site.

‘Homely’ environment/atmosphere

Women tend to prefer more homely environments but preferences may be weaker than for other attributes.

Style of decision-making

Many women attach considerable importance to models of decision-making in which the woman is involved in decisions about her care.

Distance

Proximity of services and/or travel time are important considerations for most women. Many women have a preference for a local unit and in some instances will trade off other preferences in order to attend a local unit, but women who have a strong preference for a consultant-led unit (or for specific services only available in a hospital with an OU) will travel further in order to access a unit where they feel safe.

Women living in remote areas may accept long travel times whereas women living in urban areas where hospitals are typically closer may be less prepared to travel.

Nulliparous women may be willing to travel further to a maternity unit that they perceive provides ‘higher quality care’.

Transfer

Women who prefer a hospital birth tend to express concern about transfer, whereas women who prefer a midwifery-led setting tend to be less concerned about transfer.

Other

Having a birth companion present, information and being kept informed, a quiet atmosphere, and having a special care baby unit (SCBU) on site are amongst other attributes found to be important.