Pregnant women's choice of birthing hospital: a qualitative study on individuals' preferences

Objective: To investigate pregnant women’s decision making in relation to their choice of birthing hospital and, in particular, their priorities regarding hospital characteristics. Methods: The focus of this study was the choice of birthing hospital among pregnant women. A qualitative interview design was used and women were recruited during their first pregnancy-related visit to a general practitioner. The interviews were conducted using a semi-structured interview guide, and a thematic analysis of the data was carried out. Results: Women made their hospital choice decision independently and they relied extensively on their own or peers’ experiences. Travel distance played a role, but some women were willing to incur longer travel times to give birth at a specialized hospital in order to try to reduce the risks (in case of unexpected events). The women associated the presence of specialized services and staff that were more qualified and experienced with increased safety. Other priorities included continuity of care (i.e., being seen by the same midwife) as well as service availability, which in this case referred to the possibility of a water birth and postnatal hoteling services. Conclusions: The choice of hospital provider appears to be strongly influenced by experience, whether personal experience or the experience of peers. However, there appears to be room for more information to be provided on safety and service attributes as an instrument for making an informed decision.