Home birth constructed as a safe choice in Iceland: A content analysis on Icelandic media

• The first study on a media presentation of planned home birth in Iceland.
• Close to full coverage of all published articles around home birth in the Icelandic media over 20 years.
• The analysis adds to the understanding of how the public media can contribute to the development of home birth.
• The main emphasis is on the concepts of choice and safety which are interpreted differently among doctors, midwives & women.

BackgroundThe rate of home birth in Iceland increased from 0.1% in the 90's, to 2.2% in 2012. As the media contributes to the development and public perceptions, engagement and use of health care, it is of interest to explore the media representation of planned home birth in Iceland.ObjectivesThe aim of this study was to explore the way in which the constructions of planned home birth are represented in the Icelandic media; the frequency with which planned home birth was discussed and by whom it was discussed; whether the discourse was congruent with practice development in the country; and if so, how such congruency was effected.MethodsData from the main newspapers in Iceland published from the beginning of 1990 until the end of 2011 were explored using content analysis.ResultsIn total, 127 items were summarized and we identified five themes: approach to safety, having a choice, the medicalization of childbirth, the relationship between women and midwives, and the reaction of the pregnant woman's local community. Central in the analysis were the importance of being able to choose a safe place of birth and the need for woman-centred care.ConclusionOverall planned home birth was not discussed with much intensity or frequency, but in general the discussion was shaped by a positive attitude. There was a distinction in the public media discourse among midwives and physicians or obstetricians who do not argue against planned home birth but who nevertheless speak with caution. The pregnant women who chose home birth found their own home to be safe and similar views were identified among women and midwives.