Women's experiences of giving birth and making decisions whether to give birth at home when professional care at home is not an option in public health care.

OBJECTIVE: To describe women's experiences of giving birth and making decisions whether to give birth at home when professional care at home is not an option in public health care.
METHOD: A phenomenological study. Interviews with seven women; four of them gave birth at home without professional assistant and three at hospital.
RESULTS: The essential structure shows that women live with huge contrasts between an inner and outer image of birth. They express trust towards themselves and giving birth, as well as to their own decision whether hospital care is needed or not. Birth can be empowering and strengthening, and is of importance for bonding with the child. In contrast, an outer image coming from the public and healthcare is characterized by risk, danger and fear of childbirth. Birth is viewed as something draining. The women waited with their decision where to give birth, in some cases until the contractions have started. The women felt left alone and punished. They also met supportive midwives and physicians who represented a personal perspective. In contrast, as a group, they were experienced as insecure and representative for the healthcare system.
CONCLUSION: The implication is to meet, and give a secure care to women with contrasting views of childbirth and not only to the large majority. Midwives and physicians should establish a trustful relationship with the women and know that they can be experienced as trustful even if they do not express a positive attitude towards giving birth at home.