1.4.f Personalizing the Decision

The concept of risk is always interpreted from a personal perspective and may not always align with the providers definition of risk (33, 34). For example, the distance to hospital, access to skilled personnel or specialized equipment, access to special foods or extended family support, and/or ability to engage in rituals, undisturbed, are all factors that may influence a person’s immediate feelings of security and safety. Even when the place of birth is planned, people will respond differently to the labour and birth environment depending on individual physical and life circumstances. Someone planning to deliver in the hospital may change their mind during labour and choose to give birth at home during labour with a skilled attendant. Other persons may plan to give birth in a community hospital but ultimately move to a different setting because of need for specialized medical care or environmental factors such as changes in weather or road conditions.