title: Does fear of childbirth or family history affect whether pregnant Dutch women prefer a home- or hospital birth?
abstract: OBJECTIVE
  It is a generally accepted idea that women who give birth at home are less fearful of giving birth than women who give birth in a hospital. We explored fear of childbirth (FOC) in relation to preferred and actual place of birth. Since the Netherlands has a long history of home birthing, we also examined how the place where a pregnant woman׳s mother or sisters gave birth related to the preferred place of birth.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  Five midwifery practises in the region Leiden/Haarlem, the Netherlands.
  
  
  METHODS
  104 low risk nulliparous and parous women.
  
  
  METHODS
  Questionnaires were completed in gestation week 30 (T1) and six weeks post partum (T2).
  
  
  RESULTS
  No significant differences were found in antepartum FOC between those who preferred a home or a hospital birth. Women with a strong preference for either home or hospital had lower FOC (mean W-DEQ=60.3) than those with a weak preference (mean W-DEQ=71.0), t (102)=-2.60, p=0.01. The place of birth of close family members predicted a higher chance (OR 3.8) of the same place being preferred by the pregnant woman. Pre- to postpartum FOC increased in women preferring home- but having hospital birth.
  
  
  CONCLUSIONS
  The idea that FOC is related to the choice of place of birth was not true for this low risk cohort. Women in both preference groups (home and hospital) made their decisions based on negative and positive motivations. Mentally adjusting to a different environment than that preferred, apart from the medical complications, can cause more FOC post partum.
  
  
  CONCLUSIONS
  The decreasing number of home births in the Netherlands will probably be a self-reinforcing effect, so in future, pregnant women will be less likely to feel supported by their family or society to give birth at home. Special attention should be given to the psychological condition of women who were referred to a place of birth and caregiver they did not prefer, by means of evaluation of the delivery and being alert to anxiety or other stress symptoms after childbirth. These women have higher chance of fear post partum which is related to a higher risk of psychiatric problems.
authors: Department of Obstetrics (K6-35), Leiden University Medical Centre, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands. Electronic address: a.sluijs@lumc.nl.
authors: Anne-Marie
authors: AM
authors: Sluijs
authors: Honours College, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands. Electronic address: cleiren@fsw.leidenuniv.nl.
authors: Marc P H D
authors: MP
authors: Cleiren
authors: Department of Obstetrics and Gynecology, University Medical Centre Groningen, Groningen, The Netherlands. Electronic address: s.a.scherjon@umcg.nl.
authors: Sicco A
authors: SA
authors: Scherjon
authors: Unit of Medical Psychology, Faculty of Health Sciences, Linköping University, Sweden. Electronic address: klaas.wijma@liu.se.
authors: Klaas
authors: K
authors: Wijma
mesh_terms: D000328:Adult; D001007:Anxiety; D002755:Choice Behavior; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000379:methods / Q000523:psychology*; D005239:Fear; D005260:Female; D006700:Home Childbirth / Q000523:psychology; D006801:Humans; D007743:Labor, Obstetric / Q000523:psychology; D008880:Midwifery; D009426:Netherlands; D036801:Parturition / Q000523:psychology*; D057240:Patient Preference / Q000706:statistics & numerical data*; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: FOC; Fear of childbirth; Home birth; Place of birth; Preference; Referral