Should Pregnant Women Be Advised To Give Birth At Home And In Midwife-Led Units?

First time mums can often be more than a bit nervous of their upcoming labour, and understandably - we've all seen One Born Every Minute. So the idea of giving birth at home might never have crossed their mind.

But new guidelines suggest home births are actually just as safe as those that take place in hospital, and if you've already had a baby, you could be encouraged to give the idea some serious consideration.

The recommendation to have a home birth or deliver your baby in a midwive-led unit comes from the National Institute for Health and Care Excellence (NICE). They've created draft guidelines for the NHS saying that second time mums with low risk pregnancies don’t need to give birth in hospitals – with the help of doctors.

Instead, they urge women to have home births or opt for a midwife-led unit delivery.

But women giving birth for the first should have the choice of either a hospital or home birth, says NICE.
 
The advice comes after new reports show how safe giving birth at home and in midwife-led units is. But the institute does suggest that midwives tell first-time mums about the “small increase in risk of an adverse outcome for the baby,” should a home birth be planned.

At the moment, only two per cent of the UK's 800,000 births a year happen at home and so following this advice could relive a huge amount of pressure on hospital staff and resources.

Mixed expert opinions

The Royal College of Midwives (RCM) supports the new guidelines.

“It is very welcome to see the guidance reflecting the latest evidence around place of birth,” says Cathy Warwick, chief executive of RCM. “For low risk women, giving birth in a midwife-led unit or at home is safe and reduces medical interventions.”

Stats show that a quarter of hospital births end in a C-section and one in eight use forceps or other assisted delivery methods.

But the RCM does make clear that they think it’s important that pregnant women have a “real choice” about where they give birth.

The Royal College of Obstetricians and Gynaecologists (RCOG) welcomes the guidelines but warns of the risks associated with home births.

If going ahead with a home birth, the RCOG says that a vehicle should be on standby should complications crop up and you need to get to a hospital quickly. And the same goes for using a midwife-led unit.

“If a woman decides on a freestanding unit she should take into consideration the significant transfer rate and time to the nearest obstetric unit,” says Professor Alan Cameron, vice president of clinical quality for the RCOG.

“The new guidelines recommend that women giving birth should have timely access to an obstetric unit if they need to be transferred to hospital for medical reasons. The close proximity of alongside midwifery units provides easier transfer and can therefore reduce stress and anxiety for the mother.”

[The Home Birth Rebellion]
[The Push For Home Births: Is It Right To Encourage Women Into Midwife-Only Procedures?]

What do you think about the new guidelines? Let us know in the comments.