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.