Low-risk pregnant women 'should be able to choose birthing location'

Friday 25th November 2011
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Pregnant women who are at a low risk of complications should be able to choose whether to give birth at home or in a hospital, scientists have suggested.

A study, published on bmj.com, showed that first-time mums who choose a home birth are at a higher risk of adverse outcomes. However, it was also shown that the overall risk is low in all birth settings.

Researchers say their results "support a policy of offering women with low risk pregnancies a choice of birth setting", and will help pregnant women to openly discuss planned place of birth with health professionals.

A team from the University of Oxford for the Birthplace in England Collaborative Group compared perinatal outcomes and interventions in labour by planned place of birth across all NHS trusts in the country.

Planned places of birth included home, freestanding midwifery units, midwife-led units on a hospital site with obstetric services and obstetric units.

Serious adverse outcomes covered stillbirth after start of care in labour, early neonatal death, brain injury, faeces in the lungs and injuries to the upper arm or shoulder during birth.

The rate of such outcomes was low in all settings, and there were no significant differences in the odds of an adverse outcome for any of the non-obstetric unit settings compared with obstetric units.

Among women who were giving birth for the first time, the risk of an adverse outcome was higher for planned home births compared to obstetric units. However, this is not true for either of the midwifery unit settings.

Meanwhile, women who had given birth before saw no significant differences in the rate of adverse outcomes between the different settings.

"For policy makers, the results are important to inform decisions about service provision and commissioning," the authors noted.

Written by Alex Franklin StortfordADNFCR-1780-ID-801222174-ADNFCR

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