Abstract
A woman has many important decisions to make once discovering a pregnancy. One of those decisions with significant implications is where the birth will take place. The primary consideration for the majority of pregnant women when making a decision about birth environment is safety. However, other factors such as attitudes of family and friends, religious reasons, and confidence in the body's ability to give birth play a factor in the choice of birth environment. It is recommended that birth attendants use the process of shared decision making to assist pregnant women in making choices related to the birth environment. This process empowers the pregnant woman and provides a woman-centered and evidence-based approach to choices related to obstetrical care.