Background In Australia, childbirth occurs largely within institutionalised settings, however this does not meet all women’s needs. Current literature has reported on women’s experiences of alternative birthplaces including birth centres, homebirth and freebirth, however there is no published data on Australian birth houses. Birth houses are low-technology, unlicensed birthplaces where women receive care from registered midwives in private practice. Knowledge of women’s perspectives and experiences of birth houses is unreported.

Aims Gain understanding of women’s motivations for accessing and experiences of birth houses; and develop insight into the role of birth houses within Australian maternity services.

Methodology Qualitative descriptive. Participants were recruited via purposive sampling. Women who used any of the three known birth houses in Australia were invited to participate and considered eligible if they laboured and/or birthed within the birth house. Data was collected via semi-structured in-depth interviews and thematically analysed. Ethical approval was granted.

Results Data analysis from interviews with ten women revealed four interwoven themes: “I knew there must be another way”, “The best of both worlds”, “Discovering a safe space” and “Transformation”. Birth houses offered women a level of choice and agency unavailable within hospital-based maternity care. While close proximity to medical facilities was important, women’s definitions of safety transcended biomedical perspectives to incorporate emotional and psychosocial wellbeing. Midwifery care within birth houses fulfilled women's needs by being informative, respectful, guided by women, demonstrating trust in normal birth and women’s abilities alongside rigorous safety considerations. Women described their experiences as transformational, life-changing, empowering, highly satisfying and positive influences for future birthplace choices.

Conclusion Women sought birth houses for safety, convenience, agency and autonomy. This study has demonstrated these needs were met within birth houses and highlight these birthplaces as a middle ground between home and hospital. High levels of satisfaction illustrate the validity of birth houses and reiterate the call for greater birthplace choice for all women. Further research is needed to further explore birth houses in Australia.