Birth houses in Australia: Discovery of safe, transformative birthplaces

Institutionalised birth settings do not meet the needs or wishes of all women. Current literature has reported on women's experiences of alternative birthplaces, however there is no published data on Australian birth houses. Birth houses are low-technology home-like birthplaces where women receive care from endorsed private practice midwives. Knowledge of women's perspectives and experiences of birth houses is unreported.

To gain understanding of women's motivations for accessing and experiences of birth houses; and develop insight into the role of birth houses within Australian maternity services.

A qualitative descriptive study was conducted in 2020. This methodology was chosen to centre women's voices of their experiences. Women who had utilised birth houses for labour and birth were invited to participate. Those who responded completed a brief questionnaire to support diversity in participant selection. Interviews were conducted via video-link, based on semi-structured open-ended questions. These were transcribed verbatim and thematically analysed.

Ten women who utilised any of three known birth houses in Australia for labour and/or birth were interviewed. Four themes were revealed: "I knew there must be another way", "The best of both worlds", "Discovering a safe space" and "Transformation" with safety interwoven through each of these.

Women sought birthplaces and care congruent with their values and knowledge. Birth houses offered women a level of agency unavailable within hospital-based maternity care. While proximity to medical facilities was important, women's definitions of safety transcended biomedical perspectives to incorporate emotional and psychosocial wellbeing. Women described their experiences in birth houses as transformational, highly satisfying, and positive influences for future birthplace choices.

Women sought birth houses for safety, convenience, agency and autonomy. This study demonstrated these needs were met within birth houses, highlighting these birthplaces as a middle ground between home and hospital. High levels of satisfaction illustrate the validity of birth houses and reiterate the call for greater birthplace choice for all women.