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Birth setting, transfer and maternal sense of control: results from the DELIVER study

  • Geerts, Caroline C1
  • Klomp, Trudy1
  • Lagro-Janssen, Antoine LM2
  • Twisk, Jos WR3
  • van Dillen, Jeroen4
  • de Jonge, Ank1
  • 1 VU University Medical Center Amsterdam, Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, Amsterdam, The Netherlands , Amsterdam (Netherlands)
  • 2 Radboud University Nijmegen Medical Center, Department of Women studies, Medical Sciences, Nijmegen, The Netherlands , Nijmegen (Netherlands)
  • 3 VU University Medical Center Amsterdam, Department of Clinical Epidemiology and Biostatistics, Amsterdam, The Netherlands , Amsterdam (Netherlands)
  • 4 Radboud University Nijmegen Medical Center, Department of Obstetrics and Gynaecology, Nijmegen, The Netherlands , Nijmegen (Netherlands)
Published Article
BMC Pregnancy and Childbirth
Springer (Biomed Central Ltd.)
Publication Date
Jan 17, 2014
DOI: 10.1186/1471-2393-14-27
Springer Nature


BackgroundIn the Netherlands, low risk women receive midwife-led care and can choose to give birth at home or in hospital. There is concern that transfer of care during labour from midwife-led care to an obstetrician-led unit leads to negative birth experiences, in particular among those with planned home birth. In this study we compared sense of control, which is a major attribute of the childbirth experience, for women planning home compared to women planning hospital birth under midwife-led care. In particular, we studied sense of control among women who were transferred to obstetric-led care during labour according to planned place of birth: home versus hospital.MethodsWe used data from the prospective multicentre DELIVER (Data EersteLIjns VERloskunde) cohort-study, conducted in 2009 and 2010 in the Netherlands. Sense of control during labour was assessed 6 weeks after birth, using the short version of the Labour Agentry Scale (LAS-11). A higher LAS-11 score indicates a higher feeling of control. We considered a difference of a minimum of 5.5 points as clinically relevant.ResultsNulliparous- and parous women who planned a home birth had a 2.6 (95% CI 1.0, 4.3) and a 3.0 (1.6, 4.4) higher LAS score during first stage of labour respectively and during second stage a higher score of 2.8 (0.9, 4.7) and 2.3 (0.6, 4.0), compared with women who planned a hospital birth. Overall, women who were transferred experienced a lower sense of control than women who were not transferred. Parous women who planned a home birth and who were transferred had a 4.3 (0.2, 8.4) higher LAS score in 2nd stage, compared to those who planned a hospital birth and who were transferred.ConclusionWe found no clinically relevant differences in feelings of control among women who planned a home or hospital birth. Transfer of care during labour lowered feelings of control, but feelings of control were similar for transferred women who planned a home or hospital birth.As far as their expected sense of control is concerned, low risk women should be encouraged to give birth at the location of their preference.

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