Where Do You Feel Safest? Demographic Factors and Place of Birth.
BACKGROUND
The vast majority of planned out-of-hospital births in the United States occur among white women; no study has addressed whether black women prefer out-of-hospital birth less or whether this racial disparity is due to other causes such as constrained access. This study sought to answer the question of whether white and black women feel safest giving birth in out-of-hospital settings at different rates and whether this answer is associated with other socioeconomic indicators.


METHODS
An interview of 634 nulliparous women during the third trimester of their pregnancy in Michigan provided data regarding where women felt safest giving birth. Feeling safest giving birth out-of-hospital was examined in relation to socioeconomic factors including race, age, household income, education, residence in a high-crime neighborhood, partnered status, and type of insurance.


RESULTS
This study found that black and white women say they feel safest giving birth in out-of-hospital settings at similar rates (11.5% and 13.1%, respectively). Logistic regression results showed that poverty and having education beyond high school were the only sociodemographic indicators significantly associated with feeling safest giving birth out-of-hospital.


CONCLUSIONS
Disparities evident in planned home birth and birth center rates cannot be explained by racial differences in feelings toward out-of-hospital birth and should be addressed more specifically in public policy and future studies.
Mickey
M
Sperlich
Cynthia
C
Gabriel
Julia
J
Seng
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D001294:Attitude to Health; D016550:Birthing Centers; D036861:Delivery, Obstetric; D003710:Demography; D004522:Educational Status; D004644:Emotions; D005260:Female; D006700:Home Childbirth; D006761:Hospitals; D006801:Humans; D016015:Logistic Models; D008824:Michigan; D036801:Parturition; D011203:Poverty; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D012449:Safety; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D044465:White People; D055815:Young Adult
birth center; health disparities; home birth; midwifery; quantitative research