Objective

During the first COVID-19 lockdown in the Netherlands (9 March-1 June 2020), the homebirth rate increased from 27 % to 37 % among women with low-risk pregnancies starting labour in primary midwife-led care (overall population: 15 % in 2020). We explored characteristics and motivations of women who change their preference from a hospital birth to a home birth.

Design

A nationwide prospective online questionnaire.

Setting

Questionnaires were distributed during the first COVID-19 wave (4 April-11 May 2020), as well as at follow-up (infant ±6 months old).

Population

Women who were pregnant during the first COVID-19 wave (N = 778), who either changed their preferred birth location from a hospital to a home birth or who maintained their original preference.

Methods and main outcome measures

We compared characteristics, anticipatory worries, and mental health between these groups, using descriptive statistics.

Results

The most frequently reported change in preferred birth location among included women was from a hospital to a homebirth (15 %). This was primarily experienced as a choice rather than out of necessity (84 %). Women preferring homebirths had fewer risk factors (-11 %, 95 % CI: -5 % to -16 %) and had higher COVID-19 related worry scores (+0.09, 95 % CI: 0.01 to 0.18; for scale: IQR 0.45-1.09) compared to women who maintained their original preference. Main concerns were the absence of the support of friends or family during or after birth, and exposure to COVID-19.

Conclusion

During the first COVID-19 lockdown in the Netherlands, women changing their preferred location of birth to a homebirth had fewer risk factors and more COVID-19 related worries pertaining to a hospital birth.

Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.