At the beginning of the 20th century, major technological changes occurred in maternity care in Europe. In connection with the introduction of good hand hygiene, advance medical equipment and use of disinfectants in the hospitals, obstetricians quickly noticed that maternal mortality decreased. This together with the rest of the medical equipment made hospital births safer. The hospitals became more attractive birth places instead of the homes. While the development from homebirth to hospital delivery went fast in Sweden, the midwives who worked in the United Kingdom and the Netherlands kept their role as primary caregiver to pregnant women by opening birth centers (freestanding clinics normally staffed by midwives offering a homely environment) and continued offering assistance with births at home, if that was the wish of the mother. Today, the United Kingdom and the Netherlands are good examples of a maternity care system with free choice where to give birth and with high patient safety. The purpose of this work is to see if Sweden can offer freedom of choice within the maternity care in accordance with Article 8 of the European Convention on Human Rights and applicable legislation. This is done by evaluating as to how maternity care is financed and the midwives’ role in the countries like the Netherlands and the United Kingdom and compared with Sweden. Today, maternity care in Sweden is severely criticized, not least by healthcare staff due to poor working environment. Pregnant women feel an uncertainty before childbirth, which has led to the government and Swedish municipalities and county councils to decide to make a major effort to improve maternity care and women's health. Within the framework of the development of the healthcare, this work suggests that a review of the freedom of choice in childbirth care would be a natural part to include in the reform.

Bakgrund: Fler kvinnor efterfrågar planerad hemförlossning. Sverige saknar en verksamhet för detta inom den offentliga hälso- och sjukvården. Tidigare forskning indikerar att det kan vara lika säkert att föda hemma som på sjukhus vid normal graviditet och förväntad normal förlossning. Kvinnors förlossningsterritorium främjas av hemlik miljö och stödjer den fysiologiska processen. Europadomstolen stadgar att valet av födelseplats är en grundläggande mänsklig rättighet. Syfte: Att beskriva barnmorskors inställning till planerad hemförlossning. Metod: Elva kvalitativa intervjuer med induktiv innehållsanalys.  Resultat: Barnmorskorna framhöll flera förutsättningar för att planerade hemförlossningar skulle anses säkra, dels att kvinnorna fattade ett informerat val, dels att de var omföderskor med tidigare normal förlossning. Barnmorskorna ansåg att sjukhusmiljön kunde anpassas och efterlikna hemmiljön för att främja trygghet. Barnmorskorna ansåg att bistå kvinnor i hemmet var ansvarsbetungande men kunde överväga detta om planerade hemförlossningar integrerades i offentlig hälso- och sjukvård. Slutsats: Barnmorskornas inställning till planerad hemförlossning var mångbottnad och tudelad. De värnade om kvinnans rätt till val av födelseplats, samtidigt som de uttryckte oro och såg risker i samband med planerade hemförlossningar, på grund av bristande medicinska och kollegiala resurser jämfört med sjukhus. Denna delade syn speglar balansen mellan att stödja kvinnors valfrihet och samtidigt säkerställa en säker förlossning. / Background: An increasing number of women desire the option of a planned home birth. As of today, Sweden lacks guidelines and infrastructure to support this. Previous research indicates that birthing at home may be equally safe compared to hospital birth in cases of normal pregnancy and expected normal births. The statutes of the European Court of Human Rights affirm that the choice of birthplace is a fundamental human right. Aim: To describe midwives’ attitudes toward planned home birth. Method: A qualitative interview study using an inductive approach with eleven midwives' interviewed. Results: The midwives emphasized several prerequisites for planned home births to be considered safe, including women making informed decisions and being multiparous with a history of previous normal deliveries. They believed that hospital environments could be adjusted to promote security and emulate home settings. While the midwives considered assisting women at home to be demanding, they were open to reconsidering this if planned home births were integrated into public healthcare. Conclusion: The midwives’ attitude towards planned home births was multifaceted and conflicted. They advocated for women’s autonomy and choice of birthplace, while simultaneously expressing concerns and seeing risks associated with planned home births due to inadequate resources and security compared to hospitals. This split perspective reflects the balance between supporting women’s autonomy while ensuring a safe delivery.