Conclusions
This survey in an inner city area showed that women who
chose birth centre care had positive experiences to report. Women
1006 A.J. Macfarlane et al. / Midwifery 30 (2014) 998–1008who satisfied the criteria for birth centre care and who booked
antenatally for care at the birth centre were significantly more
likely to rate their care as good or very good overall than
corresponding women who received care initially at the hospital.
Women who started labour care at the birth centre were significantly
more likely to be cared for by a midwife they had
already met, have one to one care in labour and have the same
midwife with them throughout their labour. They were also
significantly more likely to report that the staff were kind and
understanding, that they were treated with respect and dignity
and that their privacy was respected. The women's views highlighted
the profound impact of staff attitudes and communication
skills on their birth experiences. This, coupled with the findings in
the Birthplace Programme that free standing birth centres had
similar levels of safety for babies and lower intervention rates for
women compared to consultant obstetric units (Birthplace in
England Collaborative Group, 2011), adds further weight to the
evidence in support of birth centre care for women without
obstetric complications. These findings about women's experiences
generally should be interpreted in the light of the information
about their experience of specific aspects of care, described in
the second of these two articles. They also raise questions about
whether and how the skills and philosophy practised in the birth
centre can be transferred to hospital settings.