The novice birthing: theorising first-time mothers' experiences of birth at home and in hospital in Australia.

OBJECTIVE: to explore first-time mothers' experiences of birth at home and in hospital in Australia.
DESIGN: a grounded theory methodology was used. Data were generated from in-depth interviews with women in their own homes.
SETTING: Sydney, Australia. PARTICIPANTS: 19 women were interviewed. Seven women who gave in a public hospital and seven women who gave birth for the first time at home were interviewed and their experiences were contrasted with two mothers who gave birth for the first time in a birth centre, one mother who gave birth for the first time in a private hospital and two women who had given birth more than once.
FINDINGS: three categories emerged from the analysis: preparing for birth, the novice birthing and processing the birth. These women shared a common core experience of seeing that they gave birth as 'novices'. The basic social process running through their experience of birth, regardless of birth setting, was that, as novices, they were all 'reacting to the unknown'. The mediating factors that influenced the birth experiences of these first-time mothers were preparation, choice and control, information and communication, and support. The quality of midwifery care both facilitated and hindered these needs, contributing to the women's perceptions of being 'honoured'. The women who gave birth at home seemed to have more positive birth experiences. IMPLICATIONS FOR PRACTICE: identifying the novice status of first-time mothers and understanding the way in which they experience birth better explains previous research that reports unrealistic expectations and fear that may be associated with first-time birthing. It demonstrates how midwives can contribute to positive birth experiences by being aware that first-time mothers, irrespective of birth setting, are essentially reacting to the unknown as they negotiate the experience of birth. Copyright 2008 Elsevier Ltd. All rights reserved.