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Sexual & Reproductive Healthcare (2015)

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Sexual & Reproductive Healthcare

j o u r n a l h o m e p a g e : w w w. s r h c j o u r n a l . o r g

The characteristics of women who birth at home, in a birth centre or

in a hospital labour ward: A study of a nationally-representative
sample of 1835 pregnant women
Amie Steel a,b,*, Jon Adams a, Jane Frawley a, Alex Broom c, David Sibbritt a
a

Oce of Research, Endeavour College of Natural Health, Level 2, 269 Wickham St, Fortitude Valley, QLD 4006, Australia
Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo,
NSW 2006, Australia
c School of Social Sciences, The University of New South Wales, Sydney, NSW 2052, Australia
b

A R T I C L E

I N F O

Article history:
Received 14 December 2014
Revised 27 March 2015
Accepted 12 April 2015
Keywords:
Birthing centre
Home childbirth
Obstetrics
Midwifery
Reproductive health

A B S T R A C T

Objectives: A womans choice of birth setting can depend on a variety of factors including her preference, availability of services and legislative environment. However, examination of the characteristics
of women in relation to their birth environment has been limited in scope and design. This study presents the comparative characteristics of women who birth at home, in a birth centre or in a standard hospital
setting.
Methods: Cross-sectional survey of women (n = 2445) identied as pregnant or recently given birth in
the 2009 survey of the young cohort (n = 8012) from the Australian Longitudinal Study on Womens
Health.
Results: Womens birth setting was associated with a variety of factors including employment status,
private health insurance, attitudes towards obstetric care, health status, use of intrapartum pain management, and adverse birth events.
Conclusion: Womens choice of birth setting may be affected by factors such as government and institutional policy, personal values, and economic situation. The conuence of these factors for individual
women can impact on the birth settings available to women and the corresponding choices they make.
A clear understanding of these factors is important to ensure women access the most appropriate birth
environment to achieve the best maternal and foetal health outcomes.
2015 Elsevier B.V. All rights reserved.

Introduction
Contemporary maternity care often affords women the choice
of various locations for the birth of their children. The birth setting
used by women is determined by a conuence of factors including womens preference [1], availability of services [2], and the
immediate legislative environment [3]. In Australia, the vast majority (96.9%) of women give birth in a standard hospital labour ward
whilst 2.2% give birth in a hospital-based birth centre and very few
labour and birth at home (0.4%) [4]. The dominance of hospitals as
a preferred birth location has arguably been interpreted as driven
by womens perception of risk [5,6] as well as their choice of maternity care provider [7]. For example, women who choose an
obstetrician as their main care provider will inevitably birth in a

* Corresponding author. Oce of Research, Endeavour College of Natural Health,

Level 2, 269 Wickham St, Fortitude Valley, QLD 4006, Australia. Tel.: +61 07 3253
9523.
E-mail address: amie.steel@uts.edu.au (A. Steel).

hospital (either public or private) as it is the formal position of obstetricians that close access to obstetric, anaesthetic, operating theatre
and resuscitation services in labour and during the immediate postnatal period is needed to ensure the safety of mother and baby [7].
Previous research suggests women receiving midwifery-led care,
rather than obstetrician-led care, may have improved maternity and
neonatal outcomes [3,8,9]. These outcomes are further supported
by additional research which emphasises the value of care being
provided by a known midwife throughout pregnancy and birth [10].
Such ndings have driven support for alternative birth environments, including hospital-based birth centres and home births, in
which midwives provide the primary care to women [1,2,1113].
The birth centre model is proposed to be supportive of womancentred care and midwifery-led service delivery whilst still providing
women the assurance of easy access to obstetric services and equipment if needed features which have been highlighted by some
as placing the birth centre model at an advantage over home birth
[14,15]. This latter benet to birth centre care may also explain national gures which highlight a difference in numbers of intended
birth centre births compared with actual birth centre births and

http://dx.doi.org/10.1016/j.srhc.2015.04.002
1877-5756/ 2015 Elsevier B.V. All rights reserved.

Please cite this article in press as: Amie Steel, Jon Adams, Jane Frawley, Alex Broom, David Sibbritt, The characteristics of women who birth at home, in a birth centre or in a hospital labour ward: A study of a nationally-representative sample of 1835 pregnant women, Sexual & Reproductive Healthcare (2015), doi: 10.1016/j.srhc.2015.04.002

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A. Steel et al./Sexual & Reproductive Healthcare (2015)

suggests a number of women who begin labour in a birth centre

are transferred intrapartum to a standard hospital labour ward [4].
Preference for birth centre care is proposed to be due to women
placing value on the experience of being in control at birth [16].
Women may also choose a birth centre due to a preference for not
wanting pharmacological pain relief, and because they value continuity of care and want to have a known midwife present at the
birth [16], approaches which are supported through birth centre services [17]. Meanwhile, admittance to birth centre care is often
restricted to women who are classied as low risk in their pregnancy [18]. This selective access and screening is justied by
arguments that midwives are not appropriately trained to provide
care to women with complex obstetric needs and birth centre care
denies women the necessary access to the services of a specialist
obstetrician and high level technical equipment such as ventilators [19]. Meanwhile clinical research indicates birth centre care,
even when following the same guidelines as standard obstetric care,
results in: fewer emergency caesarean sections and vacuum extraction (for multiparous); less frequent epidural use; decreased
incidence of foetal distress; and lower rates of anal sphincter tears
[11,20].
Despite attempts to facilitate a woman-centred birth environment in hospital settings through birth centres, a small number of
women still choose to birth at home [1,12,16,21]. The decision to
birth at home remains highly controversial and is viewed by some
as highly risky to mother and baby [15], and by others as vulnerable to current policy review and possible legislative change [22].
Women, in turn, report experiencing negativity from hospital staff
in response to a decision to birth at home [23]. These issues contrast with the available evidence indicating that when comparing
the benets and harms of planned hospital births and planned home
births for low-risk pregnant women, home birth can be appropriate and safe if attended by a qualied midwife and the transfer
between home and hospital is uncomplicated [24,25]. In contrast,
compared with birth centre births, hospital births have been found
to result in a higher incidence of interventions and complications
[24].
Proponents of hospital-based birth centres argue that managers of these facilities attempt to minimise the risk of home birth
whilst still offering many of the advantages of an intimate birth
setting supported by midwifery-led care thereby encouraging natural
and low intervention birth [26]. In line with this, research suggests there are some shared characteristics between women who
choose to give birth at home and those who opt for a birth centre
for their labour and birth. For example, both groups of women are
more likely to experience birth place as affecting motherinfant
bonding and less likely to view birth as a medical process compared with those women birthing in hospital [27]. Likewise, those
using birth centre care/home birth articulate an intention to use
medical care if and when necessary [5]. Women choosing home birth
are reported to be well-informed about the options available to them
whilst many women planning a hospital birth appear to perceive
hospital-based care as the only option [2]. Women birthing at home
have been described as older, more educated, more feminist, more
willing to accept responsibility for maintaining their health, better
read on childbirth, and more likely to be multiparous [28]. These
women also tend to rate their midwives much higher than labourward mothers [27,28]. However, other research has suggested that
women who choose hospital births tend to be older, have a higher
family income, a higher rate of miscarriage, and are more frequently pregnant after assisted reproduction than those who choose
a home birth [6]. Ultimately, women strongly value their autonomy of choice regarding the location at which they will give birth
[29].
The growing body of research which informs our understanding of womens choice of birth environment has been primarily based

on qualitative research which focuses on women who have accessed a dened birth setting (e.g. home birth) [1,5,21,27].
Additionally, preliminary analysis has examined the characteristics of groups of women using different birth environments, but these
data have been drawn from small data sets with limited
generalisability [6,13,16,28].
Aim
This paper provides the rst comparison of the demographic,
health and attitudinal characteristics of a large, nationallyrepresentative sample of women who have given birth in a hospital
labour ward, hospital-based birth centre, or at home.
Methods
The Australian Longitudinal Study on Womens Health (ALSWH)
was established in 1996 from a sample of women randomly selected from the Medicare database. The sample was subsequently
divided into three cohorts, older (born 19211926), mid-age (born
19461951) and younger (born 19731978). The ALSWH was designed to examine demographic, social, physical, psychological and
behavioural variables and their effect on womens health and wellbeing. In 2009, women from the younger ALSWH cohort (n = 8012)
participated in their fth survey and those who identied as being
pregnant of having recently given birth at this time were invited
to complete a sub-study in 2010 (n = 2445). The sub-study survey
examined demographics, a range of maternity health service utilisation and attitudes and perceptions towards different maternity
care. Ethics approval for the sub-study was gained from the relevant ethics committees at the University of Newcastle (#H2010_0031), University of Queensland (#2010000411) and the
University of Technology Sydney (#2011-174N).
Demographics
Women were asked to identify their employment and marital
status, level of education, residential location (categorised as urban
or rural), perceived income manageability, and health care insurance coverage.
Attitudes towards maternity care
Participants were invited to rate their agreement with a range
of attitudinal statements related to their maternity care provision
through a Likert scale. These statements included whether the
women perceived any differences between conventional care providers, and features of their maternity care considered important
by the women.
Use of maternity care health services and treatments
The women were asked to identify any health services or treatments used for pregnancy-related health conditions. In addition,
womens use of intrapartum pain management techniques was examined including: breathing techniques; massage; hypnotherapy;
transcutaneous electro nerve stimulation (TENS), water therapy,
acupuncture/acupressure, nitrous oxide; pethidine; epidural; local
anaesthetic and general anaesthetic.
Pregnancy health, outcomes and history
The women were asked to identify the birth outcomes for their
most recent birth including occurrence of premature birth, caesarean section after onset of labour, and induction of labour. Women
were also asked to report any history of adverse birth events such

Please cite this article in press as: Amie Steel, Jon Adams, Jane Frawley, Alex Broom, David Sibbritt, The characteristics of women who birth at home, in a birth centre or in a hospital labour ward: A study of a nationally-representative sample of 1835 pregnant women, Sexual & Reproductive Healthcare (2015), doi: 10.1016/j.srhc.2015.04.002

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Table 1
Relationship between demographics and birth environment (n = 1835).
Demographics

Employment status
Health care subsidy
Marital
Residential location
Ability to manage on available income

Level of education

Temporary employment/unemployed
Health care card
Private health insurance
Married/de facto
Urban
Rural/remote
Impossible
Sometimes dicult
Not too bad/easy
High school certicate or less
Trade certicate/diploma
University degree or higher

as caesarean section delivery, prolonged labour (>36 hours), postpartum haemorrhage, and low birth weight baby.
Statistical analysis
Frequencies were determined for all key variables. The characteristics of women who birthed in different settings were identied
through comparative analysis between categorical variables using
Fisher exact tests. Fisher exact tests were employed to attenuate the
impact of small cell sizes. All analyses were performed using Stata
11.1 and statistical signicance was set at p = 0.05. A modied
Bonferroni correction was used to compensate for multiple
testing.
Results
The survey response rate was 79.2% (n = 1835). As seen in Table 1,
the majority of women lived in an urban setting (62.4%), were
married or in a de facto relationship (96.3%), and had an undergraduate or postgraduate university degree (59.1%). Women most
commonly birthed in a hospital labour ward (n = 1757) with much
lower numbers in a birth centre (n = 49) or at home (n = 29). Fisher
exact analysis of the association between demographics and birth
setting identied a relationship between employment status and
birth setting (p = .004) whereby women who gave birth in an institutional environment such as a birth centre (62.5%) or a hospital
labour ward (64.8%) were more likely to be in permanent employment whilst the women who gave birth at home were more likely
to be in temporary employment. The level of private health insurance status was also identied as inuential (p = .002) as women
with private health insurance had an increased likelihood of giving
birth in a hospital labour ward (71.9%) but not a birth centre (54.2%)
or at home (51.7%). Level of education was also found to relate to
womens choice of birth environment (p = .001) as women who gave

Birth centre
(n = 49)
n (%)

Community
(n = 29)
n (%)

Hospital labour ward

(n = 1757)
n (%)

P value

18 (37.5)
4 (8.2)
26 (54.2)
48 (98.0)
42 (85.7)
7 (14.3)
11 (22.5)
11 (22.5)
27 (55.1)
5 (10.2)
3 (6.1)
41 (83.7)

19 (65.5)
3 (10.3)
15 (51.7)
29 (100.0)
21 (72.4)
8 (27.6)
4 (13.8)
6 (20.7)
19 (65.5)
1 (3.5)
8 (27.6)
20 (69.0)

615 (35.2)
164 (9.4)
1255 (71.9)
1683 (96.2)
1071 (61.6)
669 (38.5)
206 (11.8)
513 (29.4)
1029 (58.9)
286 (16.4)
424 (24.3)
1034 (59.3)

0.004
0.95
0.002
0.78
0.001
0.20

0.001

birth in a birth centre (83.7%) or home (69%) more commonly had

university qualications compared to women who gave birth in a
standard hospital labour ward (59.3%).
Women who gave birth in a labour ward most commonly reported feeling more comfortable discussing the birth expectations
with an obstetrician as compared with a midwife (26.0%) in comparison with those women who used a birth centre (4.6%) and
women who gave birth at home (0.0%) (p < .001) (see Table 2). Similarly, a perception of safety during birth due to support from a
specialist obstetrician was commonly held by women who birthed
in a labour ward (73.7%) but less commonly by women who gave
birth at home (16.7%) or at a birth centre (10.5%) (p < .001).
Table 3 presents the relationship between health history and
health service utilisation. Women with sleeping problems were less
likely to choose a hospital to give birth, and more likely to choose
a home birth (p = .002). Women who reported having anaemia during
pregnancy were less likely to birth in a hospital (p = .003). Those
women who identied as preparing for labour were notably more
likely to birth in a birth centre rather than at home or in a labour
ward (p < .001). The use of non-pharmacological pain management techniques such as breathing techniques (p < .001),
hypnotherapy (p = .001), water (e.g. bath, birthing pool or shower)
(p < .001), and acupuncture/acupressure (p < .001) was reported signicantly more frequently by women who did not birth in a labour
ward. In contrast, whilst also related to birth setting, the use of pharmacological pain management such as nitrous oxide (p < .001),
pethidine (p < .001), and epidural (p < .001) was reported primarily by women who birthed in a hospital labour ward, with the
exception of nitrous oxide which was also frequently identied by
women who gave birth in a birth centre. Neither pethidine nor epidural was reported by any woman who chose to birth at home.
Women who identied as having an induction for their most recent
birth were most commonly found to give birth in a hospital labour
ward (p < .001), as were those women with a previous history of a
caesarean section delivery (p < .001).

Table 2
Relationship between attitudes towards maternity care and birth environment (n = 1835).
Attitudes

Birth centre
(n = 49)
n (%)

Community
(n = 29)
n (%)

Hospital labour ward

(n = 1757)
n (%)

P value

My preferred birth choices were respected and supported by my maternity carer

I felt more comfortable discussing my expectations of my birth with an obstetrician than a midwife
I felt more comfortable discussing my expectations of my birth with a GP than a midwife
It is important to me that my preferred birth choices are respected and supported by my maternity carer
I feel safer during birthing knowing that I have a specialist obstetrician supporting me
It is not important to me that I have support from my maternity carer in the rst few weeks after birth

48 (98.0)
0 (0.0)
(0) 0.0
47 (95.9)
4 (10.5)
4 (8.3)

27 (93.1)
1 (4.6)
0 (0.0)
29 (100.0)
4 (16.7)
4 (14.3)

1521 (90.2)
363 (26.0)
138 (10.0)
1566 (92.2)
1172 (73.7)
318 (18.4)

0.19
<0.001
0.009
0.22
<0.001
0.18

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Table 3
Relationship between health history and health service utilisation, and birth environment (n = 1835).

Pregnancy-related health conditions:

Hip pain
Sleeping problems
Preparing for labour
Tiredness or fatigue
Anaemia
Intrapartum pain management:
Breathing techniques
Massage
Hypnotherapy
TENS machine
Bath, birthing pool or shower
Acupuncture/acupressure
Nitrous oxide
Pethidine
Epidural
Local anaesthetic
General anaesthetic
Birth history:
Caesarean section
Labour >36 hours
Episiotomy
Vaginal tear (requiring stitches)
Forceps or ventouse suction
Medical removal of placenta/blood clots
Postpartum haemorrhage
Low birth weight baby
Emotional distress

Birth centre
(n = 49)
n (%)

Community
(n = 29)
n (%)

14 (28.6)
13 (26.5)
25 (51.0)
21 (42.9)
9 (18.4)

12 (41.4)
10 (34.5)
11 (37.9)
16 (55.2)
5 (17.2)

358 (20.4)
256 (14.6)
365 (20.8)
612 (34.8)
122 (7.0)

0.01
0.002
<0.001
0.05
0.003

43 (93.5)
20 (50.0)
5 (12.5)
6 (15.4)
39 (81.3)
4 (10.0)
16 (38.1)
1 (2.6)
4 (10.0)
1 (2.6)
0 (0.0)

24 (85.7)
16 (59.3)
4 (15.4)
4 (16.0)
19 (70.4)
6 (23.1)
2 (7.7)
0 (0.0)
0 (0.0)
0 (0.0)
0 (0.0)

1020 (67.4)
490 (34.8)
51 (3.8)
104 (7.6)
518 (35.9)
39 (2.9)
757 (51.1)
284 (20.6)
821 (53.1)
96 (7.2)
32 (2.4)

<0.001
0.006
0.001
0.05
<0.001
<0.001
<0.001
<0.001
<0.001
0.34
1.00

2 (4.4)
4 (8.9)
5 (11.4)
31 (67.4)
8 (17.8)
7 (15.6)
5 (10.9)
3 (6.7)
10 (22.2)

1 (3.6)
3 (10.3)
6 (21.4)
15 (53.6)
6 (21.4)
7 (25.0)
4 (14.8)
0 (0.0)
4 (13.8)

616 (37.1)
115 (7.0)
441 (26.9)
796 (48.5)
479 (29.1)
227 (13.8)
174 (10.6)
118 (7.2)
472 (29.0)

<0.001
0.57
0.05
0.04
0.19
0.22
0.68
0.40
0.13

Discussion
This study presents the rst comparative analysis, drawing on
a nationally-representative sample, of the characteristics of women
based on their choice of birth setting. The ndings from the analysis highlight some key differences between women who birth in
a standard hospital labour ward and those who birth elsewhere (i.e.
birth centre and home). Women with private health insurance are
more likely to birth in a labour ward. This trend may be linked to
an increased likelihood for women with private health insurance
to engage a private obstetrician for their maternity care as obstetricians do not support home birth in Australia [15] and birth centres
provide midwifery-led models of care [18]. This nding conicts with
current best evidence which indicates that women receiving
midwifery-led care are less likely than women receiving other forms
of maternity care to experience amniotomy, the use of regional analgesia, episiotomy, and instrumental delivery. These same women
are also more likely to experience spontaneous vaginal birth, a longer
mean length of labour, and to be attended at birth by a known
midwife [9]. In addition, women in midwifery-led maternity care
models are more likely than those receiving obstetric care to initiate breast feeding and report feeling more in control of their birth
experience [3,8].
The restrictions of hospital-based birth centre policy may be
driving the increased rate of women with previous caesarean section
delivery giving birth in hospitals, as many birth centre programmes
do not allow women to attempt trial of vaginal birth after caesarean [18], a nding of interest to policy makers. The higher rate of
hospital labour ward births amongst this subset of women may also
reect an increased rate of transfer for those women who choose
a birth centre or home environment for their trial of vaginal birth
after caesarean but experience complications resulting in transfer
to a hospital [18]. It is also likely that a number of women who have
had a previous caesarean delivery choose to birth in a hospital as
their rst preference due to personal concerns about risk [5]. Recent

Hospital labour ward

(n = 1757)
n (%)

P value

research has also indicated that low risk women who choose a hospital birth have been found to perceive birth as medically risky and
are not as concerned about the potential for overuse of obstetric
interventions as women utilising other birth environments [5,6]. This
latter nding offers an additional insight into the relationship
between the occurrence of operative delivery and birthing in a standard hospital setting and suggests that the increased likelihood of
operative births may be as much related to the womans personal
values as to the birth environment. In line with this premise, our
study has highlighted the preference expressed by women who give
birth in a labour ward towards being under the care of an obstetrician. The attitudes of women birthing in labour ward towards
obstetric care may offer some explanation as to the low reported
rates of birth centre use, possibly suggesting the choice to birth in
a labour ward may be as much or more likely due to womens
decision-making during pregnancy being constrained by social and
cultural factors associated with the concepts of risk, blame and responsibility [5] as the use of best evidence [11].
The rate of pharmacological analgesia use is signicantly higher
for women who birth in a hospital compared with those who birth
in a non-hospital setting in our study. Existing research highlights
the variety of non-pharmacological pain management options available through birth centres in Australia including water (baths and
showers), hot packs, transcutaneous electrical nerve stimulation
(TENS), acupuncture, aromatherapy, massage, naturopathy, reexology, and hypnobirthing [17]. There is also evidence that the
philosophy of the carer may be inuential, as midwives who provide
the primary care in both birth centre and home birth environments tend to align themselves more strongly with nonpharmacological pain management options within their own practice
[30]. However, other research also emphasises the value placed on
the availability of non-pharmacological pain management and the
freedom for autonomous decision-making around intrapartum pain
management options amongst women who choose a home birth
[1,27]. Women who birth at home are not beholden to hospital poli-

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cies regarding their labour progress and the possibility of obstetric

intervention [18]. This can result in women feeling more able to not
only manage their intrapartum pain management options but also
experience a higher degree of privacy and intimacy, and control the
application of medications, interventions and surgery [16]. Furthermore, a number of women who birth at home are attracted to
the idea of a personalised birth experience which they do not perceive to be available in an institutionalised birth setting [21] and
this may explain their higher use of some non-pharmacological analgesic options not less commonly supported in institutionalised
settings [17].
Our analysis shows there are many shared characteristics between
women who give birth in a hospital-based birth centre compared
with those who give birth at home, but also some differences.
Women who birth in a birth centre are more likely to have a university level education than women who birth at home or in a
hospital labour ward. These ndings add a new dimension to existing data which indicates women who birth at home have a higher
level of education than those who birth in hospital [27,28] although this relationship is not consistent across all studies [6]. Our
study also identies an additional dynamic whereby women who
choose a birth centre are more likely to have a university degree
(or higher) than either women who choose a home birth and those
who elect to birth in a hospital. Whilst it is not possible to clearly
determine the reason for these ndings, it is possible that these
women have a higher level of health literacy [31] and consider
midwifery-led or birth centre care [8,20] to be most appropriate to
their care needs whilst also valuing access to technology and specialist obstetric care if required. This nding requires consideration
from maternity care providers when engaging with women who are
birthing outside of a hospital labour ward as they may have higher
expectations of information to support their decision-making.
Women who chose to birth at home were found in our study
to be less likely to be in permanent employment compared with
women who gave birth in an institutionalised setting (e.g. birth
centre or labour ward). This is an interesting outcome given the lack
of subsidised funding for home birth in many areas of Australia and
the need for women to pay out-of-pocket for their maternity care
[22]. However, this trend may also reect a sense of safety and familiarity with the home environment, a quality reportedly valued
by women choosing home birth due to an increased time spent at
home [1,21]. It is also possible that women opting to birth at home
may not be in permanent employment as they have other children and are choosing this birth environment to allow their older
children the opportunity to be in attendance during the birth [1,21].
This preference may also extend beyond their children to their
support network more generally as women who birth at home have
been found to value the ability to select their own team of support
people and the degree to which their chosen support network is
involved in the birth experience [1,16,21]. Women may also be less
likely to be in permanent employment because their partners
income is sucient to cover expenses, however as income manageability was not found to be signicant it is unclear how relevant
this may be. However, as this study is the rst to identify an association between home birth and employment status additional
examination is needed before the nature of the relationship between
these two variables can be claried.
This study draws upon a large, nationally-representative sample
to examine a topic which has received little research attention to
date. However, the ndings of this study may be limited by the crosssectional survey design as this does not allow identication of causal
relationships. The survey also relied on self-report and as such may
be subject to recall bias. The small sample sizes of some categories may also present a limitation, however we have accommodated
this by applying the Fisher exact test and Bonferroni correction to
our analysis. A more sophisticated analysis through logistic regres-

sion was not possible, however, and as such potentially important

factors such as parity may impact on the ndings. The study is also
at risk of sampling bias due to the age range of the ALSWH cohort
(3237 years) which by its nature excludes younger and older
mothers. Despite these limitations, this study provides a valuable
insight to an under-researched topic within the eld of maternity
health services research.
This study examines the comparative difference in characteristics between women who give birth in a hospital labour ward, birth
centre or home environment. A range of characteristics were identied including employment status, health insurance coverage, level
of education, attitudes towards maternity carer, pregnancy health
history and use of complementary and alternative medicine during
pregnancy and birth. In particular, this study provides some clarity
to the similarities and differences for women who choose to give
birth at home compared with those who opt to give birth in a birth
centre. The ndings from this study provide valuable insights to maternity care providers, users, researchers and policy makers.
Acknowledgements
The Australian Longitudinal Study on Womens Health, which
was conceived and developed by groups of interdisciplinary researchers at the Universities of Newcastle and University of
Queensland, is funded by the Department of Health and Ageing, Australian Government. We thank all participants for their valuable
contribution to this project. We also thank the NHMRC for funding
JA via an NHMRC Career Development Fellowship as well as the ARC
for funding this project via their Discovery Project Funding
(DP1094765) and for funding AB via an ARC Future Fellowship. The
authors declare that they have no conict of interest.
Conict of interest
We declare that no authors have real or potential conicts of interest related to this study.
Details of ethics approval
This project has obtained ethical approval from the University
of Newcastle (#-2010_0031), University of Queensland
(#2010000411), and the University of Technology Sydney (#2011174N), and all participants gave informed consent before taking part.
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Please cite this article in press as: Amie Steel, Jon Adams, Jane Frawley, Alex Broom, David Sibbritt, The characteristics of women who birth at home, in a birth centre or in a hospital labour ward: A study of a nationally-representative sample of 1835 pregnant women, Sexual & Reproductive Healthcare (2015), doi: 10.1016/j.srhc.2015.04.002