title: Giving birth in Greenland: secular change in acceptance of hospital deliveries.
abstract: OBJECTIVE
  Until recently, deliveries usually took place at local hospitals. In 2001- 2003, new guidelines were introduced to streamline the criteria for referral to the obstetrical department in Nuuk. This led to an increase in the proportion of deliveries in Nuuk but met with some public criticism. The purpose of this article is to describe the policies for delivery in a historical context and to analyse the response of the general population to the question of what is the preferred place of delivery.
  
  
  METHODS
  Cross-sectional countrywide health interview surveys conducted in 1993-1994 and 2005-2008.
  
  
  METHODS
  In 1993-1994 and 2005-2008, 1,219 and 2,154 adult survey participants lived outside Nuuk and answered questions about their preferred place for deliveries in cases of normal and at-risk pregnancies. Answers were analysed according to age, gender, ethnic group, social position and place of residence.
  
  
  RESULTS
  The percentage of women from other towns who gave birth at the central hospital in Nuuk almost doubled from 2001 to 2005, increasing from 10.1% to 19.8%. In 1993-1994, 74.2% of survey participants preferred to have normal deliveries at the local hospital compared with 85.3% in 2005-2008. In 1993-1994, 21.3% preferred having at-risk deliveries at the obstetrical department in Nuuk compared with 45.7% in 2005-2008.
  
  
  CONCLUSIONS
  The general population has increasingly accepted the professional point of view that deliveries should take place in hospital and in a specialized department if needed. Whether this is due to the increased focus of the health care professionals on referrals since 2001 or to general societal changes is not known.
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, Copenhagen, Denmark. pb@sdu.dk
authors.forename: Peter
authors.initials: P
authors.lastname: Bjerregaard
authors.forename: Ingelise
authors.initials: I
authors.lastname: Olesen
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000639:trends*; D005260:Female; D006116:Greenland; D006801:Humans; D007407:Interviews as Topic; D009775:Obstetrics and Gynecology Department, Hospital / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D055815:Young Adult