Exploring women's preferences for birth settings in England: A discrete choice experiment.

Abstract

ObjectiveTo explore pregnant women's preferences for birth setting in England.DesignLabelled discrete choice experiment (DCE).SettingOnline survey.SamplePregnant women recruited through social media and an online panel.MethodsWe developed a DCE to assess women's preferences for four hypothetical birth settings based on seven attributes: reputation, continuity of care, distance from home, time to see a doctor, partner able to stay overnight, chance of straightforward birth and safety for baby. We used a mixed logit model, with setting modelled as an alternative-specific constant, and conducted a scenario analysis to evaluate the impact of changes in attribute levels on uptake of birth settings.Main outcome measuresWomen's preferences for birth setting.Results257 pregnant women completed the DCE. All birth setting attributes, except 'time to see doctor', were significant in women's choice (pConclusionsWe found that 'safety for the baby', 'chance of a straightforward birth' and 'can the woman's partner stay overnight following birth' were particularly important in women's preferences for hypothetical birth setting. If all birth settings were available to women and they were aware of the differences between them, it is likely that more low risk women who currently plan birth in OUs might choose a midwifery unit.