The National Institute for Health and Care Excellence (NICE) said home births and midwife-led centres were better for mothers and often as safe for babies. Professor Mark Baker, clinical practice director at NICE, said, “Most women are healthy and have straightforward pregnancies and births. Over the years evidence has emerged which shows that, for this group of women, giving birth in a midwife-led unit instead of a traditional labour ward is a safe option. Research also shows that a home birth is generally safer than hospital for pregnant women at low risk of complications who have given birth before.”
About 700,000 babies are born each year in England and Wales, nine out of 10 in doctor-led obstetric units in hospital. The new evidence found that outcomes for all babies were the same across all settings, except for those being born at home to first-time mothers, where the risk of a serious medical problem is higher.
Susan Bewley, professor of complex obstetrics at King’s College London and part of the team that developed the guidelines, said, “Midwifery-led settings have better outcomes for mothers than the traditional obstetric units and labour wards. They may be particularly suitable for all women because the rates of intervention are lower. There isn’t a one-size-fits-all model for all women and that’s why a range of settings providing different support for women with different needs gives you better safety overall.”
The new advice should save the NHS money as it is more expensive to give birth in hospital than in a specialist birth unit or at home. Critics say that could force women into giving birth without doctors, against their wishes. Midwives say its vital women are given the choice of where to deliver so they can make their own informed decisions.
Cathy Warwick, chief executive of the Royal College of Midwives, said, “I think women are reluctant to give birth out of hospital because they believe hospitals are safest. In fact for those who don’t have problems during pregnancy – we now know, this isn’t true. It’s very safe in midwifery left units or at home. In fact the outcomes for women are better and outcomes for babies just as good.”