Birthing Outside the System: Wanting the best and safest. A grounded theory study about what motivates women to choose a high-risk homebirth or freebirth

Childbirth in Australia occurs largely in a medicalised context, with 96.9% of births occurring in hospital, 2.2% in birth centres and 0.4% at home as planned homebirths (Li, Zeki, Hilder, & Sullivan, 2013). Only a small percentage of women choose to birth outside the system – that is, have no midwife present (freebirth), or elect to have a homebirth with medical risk factors. In Australia, women with risk factors have little choice but to birth in hospital under obstetric care as they are often excluded from midwifery care programs, birth centres and publicly funded homebirth. In Australia, the choice to birth at home is often met with hostility from medical practitioners, while attracting disapproval from the majority of society. It is within this context that the women in this study have made their choice to birth outside the system. The research question for this study is: what motivates women to birth outside the system – that is, to have a homebirth with risk factors present, or a freebirth where the birth at home is intentionally unattended by health professionals.