Women's Decision-Making And Factors Affecting Their Choice Of ...

Two studies form the foundation of the thesis; one is a systematic
literature review of women's views about factors influencing their choice of place
of birth, to demonstrate how much research is available, and therefore how much
work still needs to be done in the area. Additionally, the review aims to highlight
factors consistently found to influence women's choice of place of birth. The
second is a primary qualitative study of women's perceptions of the process of
childbirth, as well as their views about factors influencing their choice of place of
delivery. It is important to conduct such a study because caring for women in a
pluralistic society requires knowledge of the diverse factors influencing their
preferences for care.
To set the scene, the thesis starts by reviewing the history of trends in
place of birth. It is thought that this might help to determine the validity of the
move, and suggest ways to redress the situation.
In most cultures, childbirth was traditionally seen as a normal
physiological event, which occurred at the woman's own home with the assistance
of other women. However, this view gradually changed, and pregnancy and
childbirth were increasingly viewed as pathological events. In Britain, birth took
place at the family home until the end of the 19th century but by the end of the
20th century, barely 1% of all births in Britain took place in the woman's home
(Tew 1990). The overriding reason for this shift in place of birth was a concern
with safety. Pre-occupation with safety during childbirth was prompted by high
levels of maternal mortality in the 1930s which resulted in professional and
political organisations, followed by the women themselves, demanding hospital
deliveries because they considered them to be safer than home births (Symonds
and Hunt 1996). In 1970, the government accepted a recommendation of 100%
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