Obstetrician Attitudes, Experience, and Knowledge of Planned Home Birth: An Exploratory Study

Background The incidence of planned home birth is increasing in the United States. The American College of Obstetricians and Gynecologists acknowledges a woman's right to make an informed choice about place of delivery, including home birth. This exploratory study measures obstetricians' attitudes, experiences, and knowledge about planned home birth, identifies associations between these factors, and compares obstetricians' responses in Ohio to those in Arizona and New Mexico. Methods A survey about attitudes, experiences, and knowledge of planned home birth was distributed to obstetricians in Ohio, Arizona, and New Mexico. Attitude and knowledge scores were calculated for each respondent and used to evaluate associations through linear regression. Attitude and knowledge scores in states that have regulation of direct entry midwives (Arizona and New Mexico) were compared to a state which does not (Ohio). Results Obstetricians in all three states reported little experience and knowledge of planned home birth and overall negative attitudes. Obstetricians with stronger knowledge did not differ in their attitudes from those with less knowledge. No statistically significant differences were found when comparing attitude and knowledge scores in Ohio to Arizona and New Mexico, but Ohio obstetricians responded most negatively to the attitude questions. Conclusions Obstetricians have limited knowledge and experience and hold very negative attitudes about planned home birth. Research is necessary to determine: 1) whether negative obstetrician attitudes would be modified by exposure to home birth education and experience, and, 2) whether negative obstetrician beliefs deter safe and timely transfer from home or compromise hospital care for transferred parturients.