This is despite moves to give women more choice over their maternity care that were outlined in a government report, Changing Childbirth, which was adopted as official policy five years ago.

Doctors prefer hospital delivery

However, GPs are concerned because they do not always have the skills to oversee a home birth in safety.

The survey, carried out by the National Childbirth Trust (NCT), found GPs "actively discouraged home births".

It found that first-time pregnant women would have to be "very determined" to go ahead with a home birth.

Roxanne Chamberlain, policy advisor at NCT, said: "GPs still tell women that home births are dangerous and some continue to remove women from their lists who insist on making their own choice regarding their maternity care.

"The NCT is disheartened and concerned that the recommendations for women centred maternity care have not brought about the change that we expected.

"In fact it appears to have fallen by the wayside. Our survey shows that health professionals have simply paid lip service to it and that the policy simply never had the teeth to bring about wholesale change in maternity care."

Wide ranging concerns

Changing Childbirth aimed to encourage women to express their choice and to get the maternity care that suited them best and in which they had confidence.

However, the NCT survey has shown that as well as concerns over birth issues, seven in ten women were not happy with their postnatal care.

Nearly a third also felt more support for mothers who wished to breastfeed was needed.

The survey also found that more than half the women were cared for by several unknown midwives and only a quarter knew the person who cared for them.

Changing Childbirth said 75% of women should know the midwife who cares for them in labour.

'Negative attitude'

Consultant obestetrician Dr Rick Porter, director of maternity services with Wiltshire Healthcare NHS Trust, said: "I don't understand why there is such a persistent level of resistance to home births among doctors when clearly large numbers of women would like to give birth that way.

"There is no adequate evidence to adopt a negative attitude on safety grounds. It is very disappointing that these figures point to inflexibility among health professionals and this, in an era of evidence-based medicine is inexplicable."

Dr Gavin Young, a member of the Expert Maternity Group which produced Changing Childbirth, said: "Women need good quality, objective, honest information about the pros and cons of home births so that they do not have to depend on the uninformed opinions of doctors and other professionals.

"It is disappointing that this does not appear to be happening."

Lack of qualifications

The British Medical Association said GPs recognised that pregnant women had a choice over delivery arrangements, but warned that not all GPs were qualified to supervise a home birth.

Dr John Chisholm said GPs must refuse care they are not qualified to provide

Dr John Chisholm, chairman of the BMA's GP Committee said doctors should ensure patients could make an informed choice and then act on their wishes.

He said: "At all times the aim should be for the patients to feel supported in their decisions and for the GPs to feel that inappropriate demands will not be placed on them.

"It is particularly important that women choosing not to have a hospital delivery should not be made to feel guilty or that this is an unreasonable or an unjustified choice, even if it does not coincide with the personal view of the doctor.

"However patients too must recognise that in the interests of providing the quality care they expect, GPs also have a choice in whether they can provide that care."