Women with low risk pregnancies should be able to choose where they give birth, concludes a study published on bmj.com today. Although it shows that first-time mums who opt for a home birth are at a higher risk of adverse outcomes, the overall risk is low in all birth settings.
The researchers say their results "support a policy of offering women with low risk pregnancies a choice of birth setting" and will enable women and their partners to have informed discussions with health professionals about planned place of birth.
The benefits and risks of birth in different settings have been widely debated in recent years, but there is a lack of good quality evidence comparing the risk of rare but serious perinatal adverse outcomes in these settings.
Perinatal refers to the period just before, during or shortly after birth.
So a team led by Professor Peter Brocklehurst from the University of Oxford for the Birthplace in England Collaborative Group set out to compare perinatal outcomes and interventions in labour by planned place of birth across all NHS trusts in England.
Planned place of birth included home, freestanding midwifery units, midwife-led units on a hospital site with obstetric services, and obstetric units.
Serious adverse outcomes included stillbirth after start of care in labour, early neonatal death, brain injury (encephalopathy), faeces in the lungs (meconium aspiration syndrome), and injuries to the upper arm or shoulder during birth.
A total of 64,538 single, full term infants born to women with low risk pregnancies were involved in the study. Factors, such as maternal age, ethnic group, body mass index and deprivation score were taken into account.
Overall, the rate of adverse outcomes was low in all birth settings (4.3 per 1,000 births) and there were no significant differences in the odds of an adverse outcome for any of the non-obstetric unit settings compared with obstetric
|Contact: Emma Dickinson|
BMJ-British Medical Journal