Discussion and conclusions
Women frequently spoke about how the distance between their home and the
place of delivery affected their maternity care. A long distance caused
women to worry in the weeks leading up to the birth about how safe their
journey would be and whether they would get to the hospital on time.
Women spoke about the risks to themselves and their baby in terms of the
safety of the different types of care and the different birth delivery
options that they faced. Women were aware of the risks that they faced
during pregnancy and labour and this was something that women reported
that they had discussed with their midwives. Across the sample women
expressed a diversity of views about the ‘safest’ type of care.
Women were aware of the availability of maternity care in the different
possible birth locations available to them. Several women had very clear
preferences. Home births were discussed in nearly all interviews,
however views on home birth varied widely. Women who wanted a home birth
contrasted the surroundings of the hospital and home.
The strengths of this study include the in-depth interviewing and
analysis that was undertaken, the multi-disciplinary nature of the
research team, and the focus on very remote and rural women. However,
the sample may not necessarily generalise to other counties, with
different types of infrastructure and cultural
expectations.20
In conclusion, in depth study of the views of women are important in
informing policy and delivery of maternity care and communication with
pregnant women.21 There are clearly identified themes
in this study that should inform discussion by healthcare teams and
policy makers.