A World Apart: The Experience of Prenatal Care for U.S. Women Who Plan Home Birth

Friday, 26 July 2013: 9:10 AM

Judith A. Lothian, RN, PhD
Graduate Nursing, Seton Hall University, South Orange, NJ

Learning Objective 1: To describe the experience of prenatal care for US women who plan home birth.

Learning Objective 2: To discuss prenatal care for women who plan home birth as a way to reduce risk and promote safety in childbirth.


The purpose of this research is to describe the experience of prenatal care for women planning a home birth.  Although the safety of planned home birth for healthy women is well established only 1% of US women choose a planned home birth.  There is little research on the experience of prenatal care for women who plan home birth in the US.

Methods: Ethnographic techniques of informal interview and participant observation were used to obtain rich descriptions of women’s experience planning (and then having) a home birth. Twenty women representing diverse backgrounds were interviewed and observed, including during prenatal visits, in their homes. Interviews were audio-recorded and transcribed. Guidelines to insure trustworthiness and protection of human subjects were followed. The data were analyzed using standard qualitative techniques—developing codes, categories and themes.


Both the content and the process of prenatal care were strikingly different than standard care. Prenatal visits were in the women’s homes, informal, lengthy, and included open discussions of concerns, information, choices, and day to day life. The prenatal care contributed to the women and midwives getting to know each other well and that worked to increase women’s knowledge of and confidence in both the process of birth and their own ability to give birth. Open, honest, relaxed communication helped the midwife identify areas of concern and personalize care. Women described prenatal care as “It’s all about me and my world”.  


The prenatal care that women who plan home birth receive is a world apart from standard prenatal care. Personalized prenatal care balances the power between women and their providers ultimately increasing confidence and decreasing fear. It also assists the midwife in meeting women’s physical, emotional and psychological needs. This model of prenatal care may reduce risk and increase safety for childbearing women.