No place like home to give birth, says study

GIVING birth at home may be the safest and cheapest option for women who already have children, according to a new study.

Researchers at the University of Oxford looked into the circumstances of 64,000 births between 2008 and 2010, and found that women at low risk of complications could give birth either at home or at a midwifery unit to save the NHS money, a choice also deemed healthy for both the mother and child.The study, which examined the relative costs of healthy births in different settings, found that a planned birth in an obstetric unit is the most expensive option for mothers who already have children, with a mean cost of £1,142 per woman. By contrast, the cost associated with home birth is about £780.

The researchers suggested that for women who have not had children before, a planned birth in a midwifery unit would also save money when compared with a planned birth in an obstetric unit. While they found that a planned birth at home for such women was also cost- saving, the authors of the report pointed out that such a course of action was “associated with poorer outcomes for the baby”.

Health economist Liz Schroder, a co-author of the study, said: “The findings of the birthplace study may encourage women – particularly women having a second or subsequent baby – to request an ‘out of hospital’ birth. And the potential for cost savings could make offering women more choice an attractive option for the NHS.”

The study looked at births in obstetric units, midwifery units located in the same hospital as an obstetric unit, free-standing midwifery units and home. It assessed NHS costs associated with the birth, including care during labour, hospital stays, pain relief and any medical procedures needed in during complications.

In Scotland, the official rate of women having “non institution” births – those which have taken place somewhere other than in a maternity unit – stands at one per cent, according to the campaign group, BirthChoiceUK, using figures provided by the Scottish Multiprofessional Maternity Development Programme.

The Royal College of Midwives said the research paved the way for changes to be made to maternity services across the UK. Deputy general secretary Louise Silverton said: “This and other research points out the substantial benefits of midwife-led care: it is better for mothers and babies, it is better for midwives and it is better for the NHS.”

Mary Newburn, head of research and information at the National Childbirth Trust, the UK’s largest charity for parents, said: “There can be important benefits for the whole family when a baby is born in a social rather than a medical environment.”

A spokeswoman for the Scottish Government said: “It is important that women are given enough information to make an informed choice about where to give birth.”

The study is published on bmj.com, the website of the British Medical Journal.