Belfast Telegraph

Friday 19 December 2014

Study backs home births for mothers

Pregnant woman
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Giving birth at home may be the safest and cheapest option for women who already have children, a study has claimed.

University of Oxford researchers looked at the circumstances of 64,000 births in England between 2008 and 2010. They found that women at low risk of complications could give birth either at home or a midwifery unit to save the NHS money and was healthy for both the mother and child.

The study looked at the relative costs of healthy births in different settings. It found that a planned birth in an obstetric unit is the most expensive option for mothers who already have children, with the mean cost of £1,142 per woman, with a planned home birth the cheapest, at £780 per woman.

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, it was suggested. The researchers found that a planned birth at home for such women was also cost-saving, but said it was "associated with poorer outcomes for the baby".

Health economist Liz Schroder, a co-author of the study, said: "At the time of the study, only half of the NHS trusts in England provided women with access to a midwifery unit, and occupancy levels were often low. 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. They assessed NHS costs associated with the birth, including care during labour, the cost of any stay in hospital, the cost of pain relief and any medical procedures needed in the case of complications.

The National Institute for Clinical Excellence has previously said that estimating the cost-effectiveness of places of birth should be a priority area for research. The study is published on bmj.com, the website of the British Medical Journal.

The Royal College of Midwives said the research paved the way for changes to be made to maternity services in 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. However, we are still seeing 96% of births taking place in hospitals and this underlines the need to make a fundamental change in the way we deliver maternity services in this country."

A Department of Health spokeswoman said: "As we modernise the NHS we have made it a priority to offer women choices in where they give birth. We want women to be able to talk through their birth plan with their midwife, to find the best option for them."

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