Childbirth safer at home than in hospital says Nice

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WOMEN are now better off giving birth at home or in midwife-led centres than in hospital where doctors are more likely to make interventions such as caesareans, the health advisory body has said.

The National Institute for Health and Care Excellence (Nice) said new evidence shows women who have had straightforward pregnancies are safer in labour when cared for by midwives, both in specialist birth centres or equally in their own home.

Women who choose to give birth in traditional labour wards at hospitals, which make up 90 per cent of all births, undergo a higher rate of intervention by specialist obstetricians, including a birth by forceps, a caesarian or an episiotomy .

Sources said they suspected busy doctors wanted to progress slow labours before the end of their shift by carrying out unnecessary caesareans, in situations where midwives would be more patient.

The evidence found that outcomes for babies were the same across all settings, except for those born at home to first-time mothers where the risk of a serious medical problem is slightly higher.

Nice urged clinical commissioning groups to ensure every area has enough services to offer all options to women.

Professor Mark Baker, Nice’s clinical practice director, said: “It’s very difficult to explain why this is happening but the closer you are to hospital and indeed if you are in hospital the more likely you are to receive hospital care and surgical interventions.”

Susan Bewley, professor of Complex Obstetrics at King’s College London, who helped develop the recommendations, added: “Some women may prefer to have their baby at home or in a midwife-led unit because they are generally safer – that is their right and they should be supported in that choice.”

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