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An Educational Intervention to Change Planned Behavior Concerning Midwife-Assisted Out-of-Hospital Childbirth


  • Jason D. Hans PhD,

  • Claire Kimberly MS

Jason Hans, PhD, 315 Funkhouser Building, Department of Family Studies, University of Kentucky, Lexington, KY 40506-0054. E-mail:


Introduction:The Business of Being Born is a documentary film that reviews the history, economics, and culture of birth in the United States, with an emphasis on viewing low-risk birth as a natural and reasonably safe experience that does not require medical intervention.

Methods: A nonequivalent control group design with 468 American university students was used to examine the potential of The Business of Being Born for changing attitudes toward, and planned behavior concerning, midwife-assisted out-of-hospital childbirth.

Results: Viewing the film had a large positive effect on planned behavior concerning midwife-assisted out-of-hospital childbirth. Rationales for planned behaviors indicated that trust and safety concerns accounted for the appeal of physician-assisted hospital childbirth over midwife-assisted out-of-hospital childbirth, but that viewing the film substantially tempered these concerns vis-à-vis midwife-assisted out-of-hospital childbirth among a large portion of participants.

Discussion: The results indicate that The Business of Being Born can increase awareness of and support for the midwifery profession, and that these changes may result in increased demand for midwifery services. However, proactive efforts must be taken to ensure that the film reaches its target audience.