title: 'Reacting to the unknown': experiencing the first birth at home or in hospital in Australia.
abstract: OBJECTIVE
  to explore the experiences of a small group of first-time mothers giving birth at home or in hospital.
  
  
  METHODS
  a grounded theory methodology was used. Data were generated from in-depth interviews with women in their own homes.
  
  
  METHODS
  Sydney, Australia.
  
  
  METHODS
  19 women were interviewed. Seven women who gave birth for the first time in a public hospital and seven women who gave birth for the first time at home were interviewed, and their experiences were contrasted with two mothers who gave birth for the first time in a birth centre, one mother who gave birth for the first time in a private hospital and two women who had given birth more than once.
  
  
  RESULTS
  these women shared common experiences of giving birth as 'novices'. Regardless of birth setting, they were all 'reacting to the unknown'. As they entered labour, the women chose different levels of responsibility for their birth. They also readjusted their expectations when the reality of labour occurred, reacted to the 'force' of labour, and connected or disconnected from the labour and eventually the baby.
  
  
  CONCLUSIONS
  knowing that first-time mothers, irrespective of birth setting, are essentially 'reacting to the unknown' as they negotiate the experience of birth, could alter the way in which care is provided and increase the sensitivity of midwives to women's needs. Most importantly, midwives need to be aware of the need to help women adjust their expectations during labour and birth. Identifying the 'novice' status of first-time mothers also better explains previous research that reports unrealistic expectations and fear that may be associated with first-time birthing.
authors.affiliation: Royal Hospital for Women, Randwick, Sydney and University of Technology, Sydney, Australia. hannahdahlen@optusnet.com.au
authors.forename: Hannah G
authors.initials: HG
authors.lastname: Dahlen
authors.forename: Lesley
authors.initials: L
authors.lastname: Barclay
authors.forename: Caroline S E
authors.initials: CS
authors.lastname: Homer
mesh_terms: D001315:Australia; D003657:Decision Making; D036861:Delivery, Obstetric / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006700:Home Childbirth / Q000523:psychology*; D006801:Humans; D007231:Infant, Newborn; D008880:Midwifery / Q000379:methods; D009035:Mothers / Q000523:psychology*; D009723:Nurse-Patient Relations; D036801:Parturition / Q000523:psychology*; D011247:Pregnancy; D012944:Social Support; D011795:Surveys and Questionnaires