Factors Associated With Interest in Birth Center Care for a Future Pregnancy: A Secondary Analysis of the Listening to Mothers in California Survey

Background Understanding future demand for midwifery‐led birth centers is critical to increasing utilization of this high‐value model of care. This study examines factors associated with interest in birth center care for a future pregnancy. Methods We analyzed data from the Listening to Mothers in California survey. The study included 1447 people who had a singleton hospital birth in 2016 and did not have a history of cesarean birth. Multivariate logistic regression models were conducted with variables that were aligned with the Coxon model of birth setting decision‐making. Results More than half of respondents ( n = 789; 54.5%) expressed interest in receiving care at a birth center in the future. Respondents were more likely to express interest in birth center care if they had experienced pressure to have an obstetric intervention (AOR 1.86, 95% CI = 1.83–1.90) or believed that birth is a natural process that should not be interfered with unless medically necessary (AOR 1.74, 95% CI = 1.71–1.78), compared to respondents who did not. They were also more likely to have sought information about hospital cesarean rates (AOR 1.50, 95% CI = 1.47–1.52), had a doula in labor (AOR 1.42, 95% CI = 1.39–1.45), and experienced mistreatment (AOR 1.23, 95% CI = 1.21–1.26). Conclusions Broadening access to midwifery‐led birth centers to accommodate future demand is needed. Providing pregnant people with comparable quality measures of birth center and hospital care may facilitate informed decision‐making. Improving the shared decision‐making abilities of healthcare providers could help prevent instances of mistreatment or undue pressure on pregnant individuals to undergo obstetrical interventions.