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

Benjamin Y. Gravesteijn; Nienke Boderie; PREPARE-consortium; Roseriet Beijers; Loes Bertens; Thomas van den Akker; Jeroen van Dillen; Arie Franx; Marion van den Heuvel; Ank de Jonge; Brenda Kazemier; Igna Kwint-Reijnders; Ben Willem Mol; Sylvia A. Obermann-Borst; Lilian Peters; Stefania Vacaru; Carolina de Weerth; Sam Schoenmakers; Christianne de Groot; Jasper 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

Benjamin Y. Gravesteijn, Nienke Boderie, PREPARE-consortium, Roseriet Beijers, Loes Bertens, Thomas van den Akker, Jeroen van Dillen, Arie Franx, Marion van den Heuvel, Ank de Jonge, Brenda Kazemier, Igna Kwint-Reijnders, Ben Willem Mol, Sylvia A. Obermann-Borst, Lilian Peters, Stefania Vacaru, Carolina de Weerth, Sam Schoenmakers, Christianne de Groot, Jasper V. Been

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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
Number of pages	9
Journal	Midwifery
Volume	144
Early online date	6 Mar 2025
DOIs	https://doi.org/10.1016/j.midw.2025.104361
Publication status	Published - May 2025

Bibliographical note

Publisher Copyright:
© 2025 The Authors

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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Choosing for a Homebirth during COVID-19 Lockdown in The Netherlands, who and whyFinal published version, 1.31 MBLicence: CC BY

Cite this

Gravesteijn, B. Y., Boderie, N., PREPARE-consortium, Beijers, R., Bertens, L., van den Akker, T., van Dillen, J., Franx, A., van den Heuvel, M., de Jonge, A., Kazemier, B., 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{b8b1932901e94e13a12a576b07d562c2,

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 = "Gravesteijn, {Benjamin Y.} and Nienke Boderie and PREPARE-consortium and Roseriet Beijers and Loes Bertens and {van den Akker}, Thomas and {van Dillen}, Jeroen and Arie Franx and {van den Heuvel}, Marion and {de Jonge}, Ank and Brenda Kazemier and Igna Kwint-Reijnders and Mol, {Ben Willem} and Obermann-Borst, {Sylvia A.} and Lilian Peters and Stefania Vacaru and {de Weerth}, Carolina and Sam Schoenmakers and {de Groot}, Christianne and Been, {Jasper V.}",

note = "Publisher Copyright: {\textcopyright} 2025 The Authors",

year = "2025",

month = may,

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

language = "English",

volume = "144",

journal = "Midwifery",

issn = "0266-6138",

publisher = "Churchill Livingstone",

}

Gravesteijn, BY, Boderie, N, PREPARE-consortium, Beijers, R, Bertens, L, van den Akker, T, van Dillen, J, Franx, A, van den Heuvel, M, de Jonge, A, Kazemier, B, 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, Benjamin Y.

AU - Boderie, Nienke

AU - PREPARE-consortium

AU - Beijers, Roseriet

AU - Bertens, Loes

AU - van den Akker, Thomas

AU - van Dillen, Jeroen

AU - Franx, Arie

AU - van den Heuvel, Marion

AU - de Jonge, Ank

AU - Kazemier, Brenda

AU - Kwint-Reijnders, Igna

AU - Mol, Ben Willem

AU - Obermann-Borst, Sylvia A.

AU - Peters, Lilian

AU - Vacaru, Stefania

AU - de Weerth, Carolina

AU - Schoenmakers, Sam

AU - de Groot, Christianne

AU - Been, Jasper V.

PY - 2025/5

Y1 - 2025/5

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.

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U2 - 10.1016/j.midw.2025.104361

DO - 10.1016/j.midw.2025.104361

M3 - Article

C2 - 40068245

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

Bibliographical note

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