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Is the Best Place to give Birth at Home or Hospital?

Where’s the best place to give birth – home or hospital?  This question has been discussed and debated for many years, with doctors, midwives and mums all providing strongly held views.  However, everyone agrees that safety of the baby and mother is the most important issue.

New guidance from NICE (the National Institute for Health and Care Excellence) states that a home birth may be just as safe as a hospital delivery. The Birthplace Study which looked into the safety of different maternity settings in almost 65,000 births in England found that provided the delivery was assessed as low risk, midwife led care was just as safe as giving birth in a consultant led hospital unit.

The key factor unsurprisingly is whether or not the birth is low risk (and if an accurate assessment of that risk can be made), as the guidance for more difficult, higher risk, births is still for the labour to be in hospital.  However, this study suggests that the previous guidance was over cautious regarding the risks from a home birth or birth in a midwife led unit, which could result in over intervention in what could potentially have been a straightforward delivery.

It will be essential however to ensure that the level of risk to each woman is appropriately assessed (both antenatally and once labour is underway), that there are sufficient numbers of appropriately trained and experienced midwives to provide the necessary support and care, and that there are viable contingency plans for any complications that may arise. Sadly, if these safeguards are not in place, what should have been a straightforward delivery could end in a devastating birth injury and/or injury to the mother.

Reassuringly however, about 40 out of every 100 births are relatively “routine” and do not require any intervention other than pain relief, and for those low risk deliveries this new guidance suggests home may be just as safe as hospital provided appropriate safeguards are in place