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The Perception of Women in Rural and Remote Scotland About Intrapartum Care: A Qualitative Study

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Abstract

Background

The views of mothers are important in shaping policy and practice regarding options for intrapartum care. Mothers in rural and remote areas face unique challenges accessing services, and these need to be well understood. Therefore, our aim was to understand the compromises that women who live in remote and rural settings, more than 1 h from a maternity unit, face regarding intrapartum care.

Methods

Qualitative semi-structured telephone interviews (n = 14) were undertaken in rural Scotland with 13 women who had young children and one who was pregnant. Interviews were transcribed and thematically analysed by two researchers.

Results

Key themes identified were women’s perceptions about risk and the safety of different pathways of maternity care and birth locations; the actual and perceived distance between home and the place of birth, and the type of maternity care available at a place of birth. Mothers in rural and remote areas face particular challenges in choosing where to have their babies. In addition to clinical decisions about ‘place of birth’ agreed with healthcare professionals, they have to mentally juggle the implications of giving birth when at a distance from family support and away from familiar surroundings. It was clear that many women from rural communities have a strong sense of ‘place’ and that giving birth in a geographical location, community and culture that feels familiar is important to many of them.

Conclusions

Health care staff need to appreciate the impact of non-clinical factors that are important to mothers in remote and rural areas and acknowledge these, even when they cannot be accommodated. Local and national policy also needs to reflect and respond to the practical challenges faced by rurality.

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Acknowledgements

The authors are grateful to the women who participated in these interviews and shared their experiences with us. Thanks also to the academic staff in Aberdeen University who read and commented on the draft article.

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Authors and Affiliations

  1. Health Economics Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK

    Verity Watson & Nicolas Krucien

  2. NHS Highland, Assynt House, Beechwood Park, Inverness, IV2 3BW, UK

    Helen Bryers & Mary Burnside

  3. Economics Division, Stirling Management School, University of Stirling, Stirling, FK9 4LA, UK

    Seda Erdem

  4. Division of Rural Health and Wellbeing, Centre for Health Science, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH, UK

    Hugo C. van Woerden

  5. Institute of Nursing and Health Research, Ulster University, Belfast, UK

    Hugo C. van Woerden

  6. Centre for Rural Health, Institute of Applied Health Science, Centre for Health Science, University of Aberdeen, Old Perth Road, Inverness, IV2 3JH, UK

    Helen Bryers

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  1. Verity Watson
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  6. Hugo C. van Woerden
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Corresponding author

Correspondence to Hugo C. van Woerden.

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Funding

This research was funded by NHS Highland.

Conflict of Interest

Verity Watson, Helen Bryers, Nicolas Krucien, Seda Erdem, Mary Burnside, and Hugo C. van Woerden have no competing interests to declare.

Data Availability

The data are held by Verity Watson and can be obtained in anonymised form for agreed research purposes with relevant ethical approval.

Authors’ Contributions

The research was initiated by HvW. HvW VW, HB and SE designed the study, and HB and VW undertook the interviews and initial qualitative analysis. All authors contributed to the paper and approved its contents.

Ethics approval

Ethical approval for this research was received from the Research Ethics Service in Scotland (NHS RES REC reference number 17/ES/0086 and IRAS study number 211209). All procedures performed in this study involving human participants were conducted in accordance with the ethical standards of institutional and/or national research committees and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

All authors have provided consent for publication of this article.

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Not applicable.

Supplementary Information

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Watson, V., Bryers, H., Krucien, N. et al. The Perception of Women in Rural and Remote Scotland About Intrapartum Care: A Qualitative Study. Patient 16, 117–125 (2023). https://doi.org/10.1007/s40271-022-00608-5

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  • DOI: https://doi.org/10.1007/s40271-022-00608-5

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