Choosing for a homebirth during COVID-19 lockdown in The Netherlands, who and why: A national prospective questionnaire study

B.Y. Gravesteijn; N.W. Boderie; R. Beijers; L. Bertens; T. van den Akker; J. van Dillen; A. Franx; M.I. van den Heuvel; A. de Jonge; B.M. Kazemier; I. Kwint-Reijnders; B.W. Mol; S.A. Obermann-Borst; L. Peters; S. Vacaru; C. de Weerth; S. Schoenmakers; C. de Groot; J.V. Been

doi:10.1016/j.midw.2025.104361

Choosing for a homebirth during COVID-19 lockdown in The Netherlands, who and why: A national prospective questionnaire study

B.Y. Gravesteijn
, N.W. Boderie
, R. Beijers
, L. Bertens
, T. van den Akker
, J. van Dillen
, A. Franx
, M.I. van den Heuvel
, A. de Jonge
, B.M. Kazemier
, I. Kwint-Reijnders
, B.W. Mol
, S.A. Obermann-Borst
, L. Peters
, S. Vacaru
, C. de Weerth
, S. Schoenmakers
, C. de Groot
, J.V. Been

Research output: Contribution to journal › Article › Scientific › peer-review

Abstract

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.

Original language	English
Article number	104361
Journal	Midwifery
Volume	144
DOIs	https://doi.org/10.1016/j.midw.2025.104361
Publication status	Published - 2025

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Tranzo_Heuvel_HomebirthCOVID19Lockdown_MW_2025Final published version, 1.31 MBLicence: CC BY

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Gravesteijn, B. Y., Boderie, N. W., Beijers, R., Bertens, L., van den Akker, T., van Dillen, J., Franx, A., van den Heuvel, M. I., de Jonge, A., Kazemier, B. M., Kwint-Reijnders, I., Mol, B. W., Obermann-Borst, S. A., Peters, L., Vacaru, S., de Weerth, C., Schoenmakers, S., de Groot, C., & Been, J. V. (2025). Choosing for a homebirth during COVID-19 lockdown in The Netherlands, who and why: A national prospective questionnaire study. Midwifery, 144, Article 104361. https://doi.org/10.1016/j.midw.2025.104361

@article{69d480ed95cf485aae591905ee7be941,

title = "Choosing for a homebirth during COVID-19 lockdown in The Netherlands, who and why: A national prospective questionnaire study",

abstract = "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.",

author = "B.Y. Gravesteijn and N.W. Boderie and R. Beijers and L. Bertens and \{van den Akker\}, T. and \{van Dillen\}, J. and A. Franx and \{van den Heuvel\}, M.I. and \{de Jonge\}, A. and B.M. Kazemier and I. Kwint-Reijnders and B.W. Mol and S.A. Obermann-Borst and L. Peters and S. Vacaru and \{de Weerth\}, C. and S. Schoenmakers and \{de Groot\}, C. and J.V. Been",

note = "Projectcode: 4200P149 (41541204)",

year = "2025",

doi = "10.1016/j.midw.2025.104361",

language = "English",

volume = "144",

journal = "Midwifery",

issn = "0266-6138",

publisher = "Churchill Livingstone",

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Gravesteijn, BY, Boderie, NW, Beijers, R, Bertens, L, van den Akker, T, van Dillen, J, Franx, A, van den Heuvel, MI, de Jonge, A, Kazemier, BM, Kwint-Reijnders, I, Mol, BW, Obermann-Borst, SA, Peters, L, Vacaru, S, de Weerth, C, Schoenmakers, S, de Groot, C & Been, JV 2025, 'Choosing for a homebirth during COVID-19 lockdown in The Netherlands, who and why: A national prospective questionnaire study', Midwifery, vol. 144, 104361. https://doi.org/10.1016/j.midw.2025.104361

TY - JOUR

T1 - Choosing for a homebirth during COVID-19 lockdown in The Netherlands, who and why

T2 - A national prospective questionnaire study

AU - Gravesteijn, B.Y.

AU - Boderie, N.W.

AU - Beijers, R.

AU - Bertens, L.

AU - van den Akker, T.

AU - van Dillen, J.

AU - Franx, A.

AU - van den Heuvel, M.I.

AU - de Jonge, A.

AU - Kazemier, B.M.

AU - Kwint-Reijnders, I.

AU - Mol, B.W.

AU - Obermann-Borst, S.A.

AU - Peters, L.

AU - Vacaru, S.

AU - de Weerth, C.

AU - Schoenmakers, S.

AU - de Groot, C.

AU - Been, J.V.

N1 - Projectcode: 4200P149 (41541204)

PY - 2025

Y1 - 2025

N2 - 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.

AB - 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.

U2 - 10.1016/j.midw.2025.104361

DO - 10.1016/j.midw.2025.104361

M3 - Article

SN - 0266-6138

VL - 144

JO - Midwifery

JF - Midwifery

M1 - 104361

ER -

Choosing for a homebirth during COVID-19 lockdown in The Netherlands, who and why: A national prospective questionnaire study

Abstract

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