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What women want: Exploring pregnant women’s preferences for alternative models of maternity care


  • Fawsitt, Christopher Godfrey
  • Bourke, Jane
  • Lutomski, Jennifer E.
  • Meaney, Sarah
  • McElroy, Brendan
  • Murphy, Rosemary
  • Greene, Richard Anthony


Depending on obstetric risk, maternity care may be provided in one of two locations at hospital level: a consultant-led unit (CLU) or a midwifery-led unit (MLU). Care in a MLU is sparsely provided in Ireland, comprising as few as two units out of a total 21 maternity units. Given its potential for greater efficiencies of care and cost-savings for the state, there has been an increased interest to expand MLUs in Ireland. Yet, very little is known about women’s preferences for midwifery-led care, and whether they would utilise this service when presented with the choice of delivering in a CLU or MLU. This study seeks to involve women in the future planning of maternity care by investigating their preferences for care and subsequent motivations when choosing place of birth. Qualitative research is undertaken to explore maternal preferences for these different models of care. Women only revealed a preference for the MLU when co-located with a CLU due to its close proximity to medical services. However, the results suggest women do not have a clear preference for either model of care, but rather a hybrid model of care which encompasses features of both consultant- and midwifery-led care.

Suggested Citation

  • Fawsitt, Christopher Godfrey & Bourke, Jane & Lutomski, Jennifer E. & Meaney, Sarah & McElroy, Brendan & Murphy, Rosemary & Greene, Richard Anthony, 2017. "What women want: Exploring pregnant women’s preferences for alternative models of maternity care," Health Policy, Elsevier, vol. 121(1), pages 66-74.
  • Handle: RePEc:eee:hepoli:v:121:y:2017:i:1:p:66-74
    DOI: 10.1016/j.healthpol.2016.10.010

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    References listed on IDEAS

    1. Joanna Coast & Hareth Al‐Janabi & Eileen J. Sutton & Susan A. Horrocks & A. Jane Vosper & Dawn R. Swancutt & Terry N. Flynn, 2012. "Using qualitative methods for attribute development for discrete choice experiments: issues and recommendations," Health Economics, John Wiley & Sons, Ltd., vol. 21(6), pages 730-741, June.
    2. Patricia Kennedy, 2012. "Change in Maternity Provision in Ireland,“Elephants on the Move”," The Economic and Social Review, Economic and Social Studies, vol. 43(3), pages 377-395.
    3. Samuelson, William & Zeckhauser, Richard, 1988. "Status Quo Bias in Decision Making," Journal of Risk and Uncertainty, Springer, vol. 1(1), pages 7-59, March.
    4. Porter, Maureen & Macintyre, Sally, 1984. "What is, must be best: A research note on conservative or deferential responses to antenatal care provision," Social Science & Medicine, Elsevier, vol. 19(11), pages 1197-1200, January.
    5. Kennedy, Patricia, 2010. "Healthcare reform: Maternity service provision in Ireland," Health Policy, Elsevier, vol. 97(2-3), pages 145-151, October.
    6. Thaler, Richard, 1980. "Toward a positive theory of consumer choice," Journal of Economic Behavior & Organization, Elsevier, vol. 1(1), pages 39-60, March.
    7. Christopher G Fawsitt & Jane Bourke & Richard A Greene & Claire M Everard & Aileen Murphy & Jennifer E Lutomski, 2013. "At What Price? A Cost-Effectiveness Analysis Comparing Trial of Labour after Previous Caesarean versus Elective Repeat Caesarean Delivery," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-8, March.
    8. Pavlova, Milena & Hendrix, Marijke & Nouwens, Elvira & Nijhuis, Jan & van Merode, Godefridus, 2009. "The choice of obstetric care by low-risk pregnant women in the Netherlands: Implications for policy and management," Health Policy, Elsevier, vol. 93(1), pages 27-34, November.
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    Cited by:

    1. Paddy Gillespie & Sharon Walsh & John Cullinan & Declan Devane, 2019. "An Analysis of Antenatal Care Pathways to Mode of Birth in Ireland," The Economic and Social Review, Economic and Social Studies, vol. 50(2), pages 391-427.
    2. Fawsitt, Christopher G. & Bourke, Jane & Greene, Richard A. & McElroy, Brendan & Krucien, Nicolas & Murphy, Rosemary & Lutomski, Jennifer E., 2017. "What do women want? Valuing women’s preferences and estimating demand for alternative models of maternity care using a discrete choice experiment," Health Policy, Elsevier, vol. 121(11), pages 1154-1160.
    3. Moran, Patrick S. & Daly, Deirdre & Wuytack, Francesca & Carroll, Margaret & Turner, Michael & Normand, Charles & Begley, Cecily, 2020. "Predictors of choice of public and private maternity care among nulliparous women in Ireland, and implications for maternity care and birth experience," Health Policy, Elsevier, vol. 124(5), pages 556-562.

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