Preferences of Recent Mums in Remote and Rural Areas for Type of Intrapartum Care: A Discrete Choice Experiment

Background and Objectives
Pregnant women living in rural areas considering their preferred place of birth may have to ‘trade-off’ travel time/distance and other attributes of care e.g., the full choice of birthplace options is rarely available locally. This study assessed the preferences and trade-offs of recent mothers who live in remote and rural areas of Great Britain.
Methods
An online survey, informed by qualitative research, was administered to women living in rural areas who had given birth in the preceding three years. The survey included a Discrete Choice Experiment (DCE) to elicit women’s preferences and trade-offs for place of birth. The DCE presented women with a series of eight choice tasks in which place of birth was defined by four attributes: (1) type of facility; (2) familiarity with staff; (3) understanding options and feel relaxed and reassured; and (4) the traveltime to the place of intrapartum care. DCE data was analysed using an error components logit model to identify preferences.
Results
Across 251 survey responses, holding everything else equal, respondents preferred:
intrapartum care in locations with more specialist staff and equipment; locations where they understood their options and felt reassured; and where travel time was minimal. Women were willing to travel (92-183 minutes) to a well-staffed and equipped facility if they understood their options, and felt relaxed and reassured. Willingness to travel was reduced if the care received at the specialist facility was such that they did not understand their options, and felt tense and powerless (41-132 minutes).
Conclusion
These insights into the preferences of recent mums from remote and rural areas could inform future planning of rural intrapartum care.