NHS push for home births: Second-time mums are told they only need hospital if high-risk

First-time mothers 'just as safe having baby in a small midwife-led unit'

Most having second child told giving birth at home is as safe as hospital

The encouragement for home births marks a major change in NHS guidance

Most women say they prefer to be in hospital to give birth

A radical shift in NHS policy will see hundreds of thousands more women encouraged to give birth at home.

Mothers-to-be will be told that unless there is a high risk of complications they do not need a hospital delivery.

First-time mothers are to be advised they are just as safe having their baby in a small midwife-led unit as on the labour ward.

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A radical shift in NHS policy will see hundreds of thousands more women encouraged to give birth at home

For most of those having their second child, giving birth at home is as safe as hospital – and far more pleasant – say new draft NHS guidelines revealed today.

The encouragement for home births marks a major change in NHS guidance, which previously advised mothers to be ‘cautious’ about having their baby at home.

 

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NICE, the NHS watchdog, says its proposals reflect recent evidence. 

But the change of policy at a time when many hospital labour wards are struggling to cope with the highest birth rate in 40 years, will lead to concerns the NHS is simply trying to save money.

Only last month, new president of the Royal College of Obstetricians and Gynaecologists Dr David Richmond warned that up to 300 babies a year are dying needlessly due to NHS staff shortages. 

Union leaders have repeatedly told ministers that the health service needs an extra 5,000 midwives to ensure proper standards of care. 

Currently, 94 per cent of the 730,000 women who go into labour in England and Wales each year give birth in hospital. Only 2.5 per cent give birth at home with the remainder going to midwife-run centres.

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Union leaders have repeatedly told ministers that the health service needs an extra 5,000 midwives

In the early 1900s nearly all women had babies at home but this fell rapidly after the creation of the NHS in 1948. 

Most women say they prefer to be in hospital to give birth in case anything goes wrong.

But having a baby at home or in a midwife-led centre is far cheaper than having a hospital birth as women do not need a hospital bed. Staffing costs in midwifery units are also lower and they tend to rely less on pain relief or other interventions.

Studies have shown a birth at home costs the NHS an average of £1,066, compared with £1,450 at midwife-led centres and £1,631 in hospital.

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Studies have shown a birth at home costs the NHS an average of £1,066, compared with £1,450 at midwife-led centres and £1,631 in hospital

Previously, NHS guidelines said mothers should be free to choose where they gave birth but urged caution over home births for women having their first child.

Women will now be advised to give birth outside hospital as long as their pregnancy is considered low risk and they do not suffer from asthma, diabetes, epilepsy or other chronic health conditions.

The draft guidelines say: ‘Midwives should explain to the mother-to-be that she may choose any birth setting... and support her in her choice.

‘Midwives should advise low-risk women who have already had at least one child to plan to give birth either at home or in a midwife-led unit.

‘Midwives should advise low risk women who are expecting their first baby to plan to give birth in a midwife-led unit. This is because women tend to have a better experience in this setting than a traditional labour ward.’

Midwife-led units aim to create a more homely environment and there are typically between four and ten beds and water-birth facilities. They are either stand-alone centres in the community or attached to hospitals. Doctors are summoned only in an emergency.

Cathy Warwick, chief executive of the Royal College of Midwives, said women had too often been denied a choice of where to give birth.

This should be at the heart of maternity strategy, she said.

A spokesman from the Royal College of Obstetricians and Gynaecologists said: ‘We support choice for low-risk women who have had successful previous births to give birth at home provided transport arrangements are in place for hospital transfer in the event of an emergency or should there be a request for pain relief.’

Read more: http://www.dailymail.co.uk/health/article-2626670/NHS-push-home-births-Second-time-mums-told-need-hospital-high-risk.html#ixzz31cBC6OeP 
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