Birth place preferences and women's expectations and experiences regarding duration and pain of labor

Tamar M. van Haaren-ten Haken*, Marijke J. Hendrix, Marianne J. Nieuwenhuijze, Raymond G. de Vries, Jan G. Nijhuis

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Web of Science)


Introduction: We know a great deal about how childbirth is affected by setting; we know less about how the experience of birth is shaped by the attitudes women bring with them to the birthing room. In order to better understand how women frame childbirth, we examined the relationship between birth place preference and expectations and experiences regarding duration of labor and labor pain in healthy nulliparous women.Methods: A prospective cohort study (2007-2011) of 454 women who preferred a home birth (n=179), a midwife-led hospital birth (n=133) or an obstetrician-led hospital birth (n=142) in the Netherlands. Data were collected using three questionnaires (before 20 weeks gestation, 32 weeks gestation and 6 weeks postpartum) and medical records. Analyses were performed according to the initial preferred place of birth.Results: Women who preferred a home birth were significantly less likely to be worried about the duration of labor (OR 0.5, 95%CI 0.2-0.9) and were less likely to expect difficulties with coping with pain (OR 0.4, 95%CI 0.2-0.8) compared with women who preferred an obstetrician-led birth. We found no significant differences in postpartum accounts of duration of labor. When compared to women who preferred an obstetrician-led birth, women who preferred a home birth were significantly less likely to experience labor pain as unpleasant (OR 0.3, 95%CI 0.1-0.7). Women who preferred a midwife-led birth - either home or hospital - were more likely to report that it was not possible to make their own choices regarding pain relief compared to women who preferred obstetrician-led care (OR 4.3, 95%CI 1.9-9.8 resp. 3.4, 95%CI 1.5-7.7). Compared to women who preferred a midwife-led hospital birth, women who preferred a home birth had an increased likelihood of being dissatisfied about the management of pain relief (OR 2.5, 95%CI 1.1-6.0).Discussion: Our findings suggest a more natural orientation toward birth with the acceptance of labor pain as part of giving birth in women with a preference for a home birth. Knowledge about women's expectations and experiences will help caregivers to prepare women for childbirth and will equip them to advise women on birth settings that fit their cognitive frame.
Original languageEnglish
Pages (from-to)19-28
Number of pages10
JournalJournal of Psychosomatic Obstetrics and Gynecology
Issue number1
Publication statusPublished - 1 Jan 2018


  • Birth experiences
  • duration of labor
  • expectations
  • labor pain
  • place of birth
  • HOME
  • RISK
  • CARE

Cite this