Table 2 Women and care providers’ views on social and clinical risk

Clinical Risk of Staying

“It is more stressful with primips. And I’ve been in the plane with two or in the helicopter overnight with two primips in the past couple of years going [to the referral community] in labour [with] stuck babies and you know it’s, it is stressful and eventually I can see … it leading to me being a lot more reluctant.” (Care Provider 1, Community 1)

“Yeah and now it’s like you know they send people off regardless and at one time I had kind of a negative attitude about that but after having seen [it] you never know when things could go really, really, really wrong and when people are stranded here with the weather. Like, there are lots of times when nothing moves. And yeah like it would be really wonderful if everybody could have their babies at home or in the hospital here but as far as safety goes, I’m not sure if that’s really an option.” (Care Provider 1, Community 1)

Social Risk of Leaving

“I would just sort of like to not even think about leaving and just [stay] at home. I would almost rather risk that kind of a trip than have to be away from home for so long.” (Participant 12, Community 2)

“[When] you have the same doctor they know what’s going on with your body … I think it would … be very uncomfortable for a first time mum to have to have seven different doctors.” (Participant 1, Community 3)

“And it’s the poorer women that sort of suffer the most. Because you know then they’re having to make the choice to stay up here. Well it’s not a choice for them. They’re having to stay up here and then, you know, having to risk the mad dash [out of the community] just because they don’t have the money to stay there. And they’re away from all their support.” (Participant 12, Community 2)

“Cause I’m a single mother and I’ve got four kids, I mean that’s a scary thing for me, and then I had to get respite set up in case I went into the hospital and I didn’t have anybody around and that was a scary thought too because then that’s getting the Ministry involved.” (Participant 7, Community 3)

“We were having children in our homes [and] we were having children naturally long before doctors came to be. We were having children just the way I had my child eight months ago.” (Participant 6, Community 2)