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

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Table 12: Other Themes Theme Home (n= 13) Hospital (n=20) Confidence in midwives 9(69%) First baby 6 (30%) Given choice of two hospitals 10 (50%) Gradual process 5(38%) Home not mentioned 9 (45%) Lack of information 18 (90%) Midwife encouraged hospital 3 (15%) No discussion with partner 15 (75%) Open mind about hospital 4(20%) Presumed decision 6 (30%) Previous bad experience 4 (20%) Previous home birth 6(46%) After identifying the themes shown in Tables 9-12 the ones that had the same meaning were grouped together, and integrated under a common more abstract theme as illustrated in Table 13: Table 13: Themes that were combined Initial themes Core theme <strong>Choice</strong> of two hospitals, midwife encouraged hospital, no information, home not mentioned, presumed decision, normal course of action Left alone, busy, shortage of staff, safety, continuous care, backup facilities, experienced staff, emergencies attended faster, short labour, good experience, easy birth, clinical environment, interventions, medicalisation, routines, influence of others, proximity to hospital, first baby best in hospital, uncertain process, open mind about hospital More comfortable/relaxed, control, freedom of movement, own environment, privacy, familiar environment, convenience, change of rooms Information Risk perception/safety Control 135
The results of the study therefore indicate that women's decision-making about the place of birth were somehow determined by factors centred on three main themes of information, risk perception/safety, and control. Most of the themes were related to risk perception. It would be useful to illustrate how the themes relate to risk perception. Most women in both groups felt that a first baby was better in hospital because one did not know what to expect and therefore it was safer to have the baby in hospital. Influence of others is related to perception of risk and safety because others' experiences, whether good or bad, at a particular venue were shown in the study to influence how women viewed that venue. For example, if one knew someone who had successfully delivered at home without any complications, their perception was that they also could have a safe birth at home. Some women just mentioned that they preferred a venue because of safety. Most women thought childbirth was an uncertain process and preferred a venue that they felt would make them safer. Women planning a home birth talked about staff shortage in hospital, and perceived that to have increased risk of things going wrong without anybody noticing on time. They therefore preferred home where they thought they would have continuous care. To the home birth group, continuous care was synonymous with safety. Women who had had a good experience at a particular venue preferred to go back to the same venue. The good experience in most cases referred to when emergencies were attended faster, or when the midwife was seen to be caring, and there were no complications. Some women planning a home birth said they had previously had easy short labour and therefore did not want to risk giving birth on the way to hospital, or perceived previous safe birth to mean safe birth this time. 136
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Women's Decision-Making And Factors
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Figure 1: The paper elimination pro
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Home themes with supporting quotati
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Acknowledgements I would like to th
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Kingdom is a pluralistic society, w
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hospital delivery following a revie
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The committee issued a press notice
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The recommendations of the report u
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home. They also put forward the fac
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equirements for the maximum lowerin
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Previous committees had made their
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The majority of those interviewed f
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The Expert Maternity Group gathered
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• The woman and, if she wishes, h
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Chapter 2: Risk perception Chapter
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From the health practitioner's pers
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1979), is a second approach to unde
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normative factor. The individual's
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and then choose the place they cons
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example, they worried that the valu
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they can easily imagine or recall a
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are not necessarily chosen because
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make decisions that are not necessa
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Chapter 3: Systematic review of fac
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considered. Primary research design
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If the question of the review is no
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Cochrane Database of Systematic rev
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Table 2: Search terms used Search t
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Table 3: Journals that were hand se
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solely on the basis of the study re
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they were recruited, at what stage
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,,, ... .g eD .E 0 o 4,7; (.5 g .5
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-o -cs •b a) ..o ,:" .., -0 ti-,
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Quality of studies included in the
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ole to play in their preferences fo
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The next chapter discusses methodol
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observable behaviour are used (Holl
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known? What roles do values play in
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male nursing home is used (Applegat
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The procedure ensures a vigorous se
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investigation have for the particip
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In method triangulation, different
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Page 87 and 88: access to all settings, and the dat
Page 89 and 90: access participants' private accoun
Page 91 and 92: There is an argument for analysing
Page 93 and 94: analysis, asking additional questio
Page 95 and 96: that while such an approach can nev
Page 97 and 98: Chapter 5: Qualitative Study of Wom
Page 99 and 100: potential participants, as well as
Page 101 and 102: either. Three months passed, there
Page 103 and 104: The interview was transcribed the s
Page 105 and 106: elevant. The environment of the hom
Page 107 and 108: wanted to explore. Consequently, th
Page 109 and 110: Most women offered coffee or tea, a
Page 111 and 112: All women who participated in the s
Page 113 and 114: The process of analysis was iterati
Page 115 and 116: h4,u husbovzi would sou thnt lie fe
Page 117 and 118: transcripts and compared them with
Page 119 and 120: ecause they previously had short un
Page 121 and 122: Figure 2: Analysis mind map Hospita
Page 123 and 124: quotation in the transcript, denote
Page 125 and 126: itiust put me off of birth, fuLL st
Page 127 and 128: Gaolape brought up a number of fact
Page 129 and 130: that presentation of much of the da
Page 131 and 132: Table 7: Marital status Place of de
Page 133 and 134: Table 9: Themes expressed by women
Page 135: Table 11: Themes expressed about th
Page 139 and 140: Box 2: Pseudonyms of study particip
Page 141 and 142: have registered so I can't remember
Page 143 and 144: you have to be veru persuasive. her
Page 145 and 146: waiAted to go to [name of hospital]
Page 147 and 148: wavut to ask about it, and theo.. V
Page 149 and 150: dedn't sort o-F tru AAA persuade me
Page 151 and 152: anuthLng went wrong theyol have aLL
Page 153 and 154: sometKng eLse when she saist, the h
Page 155 and 156: arou.nd their necIR. all the time A
Page 157 and 158: senuona: Mu fLrst one I had Ln hosp
Page 159 and 160: agaLvt. when I had mu episiotomu th
Page 161 and 162: khuma. iviu first daughter was a ca
Page 163 and 164: nolope: olzau, I'LL give uou a fi.n
Page 165 and 166: thought it would be, thlngs have oh
Page 167 and 168: wtedwefe came around and spolze to
Page 169 and 170: Some of the spontaneous responses f
Page 171 and 172: or home. One woman thought that pro
Page 173 and 174: N yttx1R,IA: we have got more contr
Page 175 and 176: Sixty-nine percent of women plannin
Page 177 and 178: expectations of what would best rep
Page 179 and 180: Committee 1992) who observed that t
Page 181 and 182: One of the fascinating findings of
Page 183 and 184: Summary The qualitative study has r
Page 185 and 186: Government policy about maternity c
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choose (DiMatteo 1994), without any
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Prospect theory (Kahneman and Tvers
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IRYLOW, we tAIR,e eVeruthi.ne im, o
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that may impact on the choices they
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conducting home births, which might
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looked after her during one of her
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Appendices Appendix 1: (Information
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Appendix 3a Consent form I the unde
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22. because I was in a hospital and
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76. the next one was being born her
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130. why are you wasting the hospit
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183. on the floor in agony go ahead
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237. went up and ran the bath for h
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292. not going near me, you know an
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346. and I said, well, you know, I
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401. it's not as ifsomething goes w
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455. you, I said , you're here to d
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510. nice. And the funny thing was
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566. through friends as well, they'
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Appendix 5: Reflective notes Nnese
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what do you think ofthe situation w
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going horribLu wrong and suoldenlu
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and he was quite sort of happy with
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60. you are dealing with somebody y
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112. Well I didn't Feel, you are to
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1.o6. like Doctors ncl nurses and t
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218. we are anti hospitals or anyth
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Appendix 8: Thematic analysis Home
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References Abraham, C., Sheeran, P.
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Beck, C. T. (1993) Qualitative Rese
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Chamberlain, J., Melia, J., Moss, S
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Davenport-Slack, B. and Boylan, C.
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Dingwall, R. (1992) Don't Mind Him
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Fordham, S. (1997) Women's Views Of
Page 255 and 256:
Hammersley, M. and Atkinson, P. (19
Page 257 and 258:
Johnson, B. B. and Covello, V. T. (
Page 259 and 260:
Leap, N. (1996) 'Persuading' Women
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Mather, S. (1980) Women's Interest
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Morse, J. M. (1999c) Qualitative Ge
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Patton, M. Q. (1990) Qualitative Ev
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Commissioned by the Expert Maternit
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Slovic, P., Fischhoff, B., and Lich
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Tew, M. (1978) The Case Against Hos
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White, V. M., Wearing, A. J., and H
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