title: How women with high risk pregnancies perceive interactions with healthcare professionals when discussing place of birth: A qualitative study.
abstract: OBJECTIVE
  to investigate women's perceptions of interactions with obstetricians and midwives during high risk pregnancies. The intention was to examine differences and similarities between women planning to give birth at home or in hospital.
  
  
  METHODS
  qualitative study using semi-structured interviews. Setting Maternity department in a hospital in South East England.
  
  
  METHODS
  twenty-six women with high risk pregnancies, at least 32 weeks pregnant. Half were planning hospital births and half homebirths.
  
  
  RESULTS
  semi-structured interviews to investigate women's perception of communication. Results were analysed using thematic analysis. Four themes emerged: women's experiences of communication about risks in pregnancy; women's perceptions of professionals' beliefs about birth; women's trust in professionals; and women's attitude to professionals' advice. Women spoke more positively about communication with midwives than with obstetricians. Women planning hospital births expressed trust in obstetricians. Women planning homebirths expressed more trust in midwives. Women planning hospital births were less likely to question advice from professionals. Women planning homebirths were more inclined to trust their own instincts when these contradicted professional advice.
  
  
  CONCLUSIONS
  women prefer to communicate with professionals who are respectful of their thoughts and feelings. They may not follow all professional advice.
  
  
  CONCLUSIONS
  professionals working with women with high risk pregnancies should acknowledge women's concerns and deliver impartial, evidence-based advice.
authors.affiliation: School of Health Sciences, City University London, Northampton Square, London EC1A 7QN, UK. Electronic address: suzanne.lee.2@city.ac.uk.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Lee
authors.affiliation: School of Health Sciences, City University London, Northampton Square, London EC1A 7QN, UK. Electronic address: susan.ayers.1@city.ac.uk.
authors.forename: Susan
authors.initials: S
authors.lastname: Ayers
authors.affiliation: Surrey and Sussex Healthcare NHS Trust, East Surrey Hospital, Canada Avenue, Redhill, Surrey RH1 5RH, UK. Electronic address: des.holden@sash.nhs.uk.
authors.forename: Des
authors.initials: D
authors.lastname: Holden
mesh_terms: D001291:Attitude of Health Personnel; D002755:Choice Behavior; D036861:Delivery, Obstetric / Q000523:psychology*; D004739:England; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006700:Home Childbirth / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008880:Midwifery; D009774:Obstetrics; D011247:Pregnancy; D018566:Pregnancy, High-Risk / Q000523:psychology*; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012306:Risk
keywords: Communication; High risk pregnancy; Homebirth