Qualitative assessment of attitudes affecting childbirth choices of Jamaican women

One proposal is to provide the option of midwife-attended birth in a specially created maternity room attached to a neighborhood clinic for women who have been screened and anticipate normal deliveries. This report presents the findings of a survey of Jamaican women and their attitudes towards various childbirth locations, namely hospitals, homes, and the proposed maternity centers. The study found that most urban women preferred hospital childbirth, primarily due to the perceived safety offered by the proximity of medical expertise for obstetric emergencies. For these women, lack of social support and poor attitudes among maternal care providers in hospitals were more disturbing than the difficult physical conditions often experienced during hospital childbirth, such as shortages of supplies or bed space. In rural areas, where childbirth often takes place at home attended by a midwife, women preferred home birth but were more receptive to the proposed alternative birth location. Conditions for acceptance included assurance of privacy, and provision of the same basic comforts and social support that home birth allows. The report also documented the women"s knowledge of and attitudes towards antenatal and obstetric risk, as well as the barriers to the use of antenatal care. Childbirth, as distinct from pregnancy, was perceived as potentially dangerous by the majority of women interviewed, although few could identify specific dangers. Barriers to antenatal care included the inability of government clinics to provide early confirmation of pregnancy, the poor attitudes of health care providers, and emotional factors such as embarrassment at unwanted pregnancies. Prior experience was found to affect both the acceptance of alternative birth locations and the awareness of risk factors.