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Birth (Berkeley, Calif.) · 2025

Factors Associated With Interest in Birth Center Care for a Future Pregnancy: A Secondary Analysis of the Listening to Mothers in California Survey.

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George Erin K, Edmonds Joyce K

Аннотация

BACKGROUND: Understanding future demand for midwifery-led birth centers is critical to increasing utilization of this high-value model of care. This study examines factors associated with interest in birth center care for a future pregnancy.

METHODS: We analyzed data from the Listening to Mothers in California survey. The study included 1447 people who had a singleton hospital birth in 2016 and did not have a history of cesarean birth. Multivariate logistic regression models were conducted with variables that were aligned with the Coxon model of birth setting decision-making.

RESULTS: More than half of respondents (n = 789; 54.5%) expressed interest in receiving care at a birth center in the future. Respondents were more likely to express interest in birth center care if they had experienced pressure to have an obstetric intervention (AOR 1.86, 95% CI = 1.83-1.90) or believed that birth is a natural process that should not be interfered with unless medically necessary (AOR 1.74, 95% CI = 1.71-1.78), compared to respondents who did not. They were also more likely to have sought information about hospital cesarean rates (AOR 1.50, 95% CI = 1.47-1.52), had a doula in labor (AOR 1.42, 95% CI = 1.39-1.45), and experienced mistreatment (AOR 1.23, 95% CI = 1.21-1.26).

CONCLUSIONS: Broadening access to midwifery-led birth centers to accommodate future demand is needed. Providing pregnant people with comparable quality measures of birth center and hospital care may facilitate informed decision-making. Improving the shared decision-making abilities of healthcare providers could help prevent instances of mistreatment or undue pressure on pregnant individuals to undergo obstetrical interventions.

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