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Landmark birthplace study

Posted on 25/11/2011

Women with straightforward pregnancies can choose whether they’d like to give birth in a hospital obstetric unit, a midwifery unit or at home, knowing that giving birth is generally very safe. But there are some important differences between these birth settings in benefits and risks for the mother and baby, the Birthplace in England study has shown.

The findings come from a landmark study of almost 65,000 ‘low risk’ births– the first of its type and scale. It included nearly 17,000 planned home births and 28,000 planned midwifery unit births.

The Birthplace study addressed the safety, costs and provision of maternity care in England according to where women with ‘low risk’ pregnancies plan to give birth. It compared women at ‘low risk’ of complications who planned to give birth in hospital obstetric units with those who planned to give birth at home or in midwifery units.

Overall, outcomes for the baby did not appear to differ between the planned places of birth.

Professor Jane Sandall from the Women’s Health Academic Centre and NIHR King's Patient Safety and Service Quality Research Centre, who co-authored the report, said: ‘These findings show that women who planned birth in midwifery-led units experienced fewer interventions with no increased risk to the baby. This was also the case for women having their subsequent babies at home.

‘The Birthplace study provides good evidence for women to make the best, informed choices for their own circumstances and preferences.’

The researchers looked at nearly 17,000 planned home births and 28,000 planned midwifery unit births.

The study found that first-time mothers planning a birth at home had an increase in poor outcomes for the babies compared with first-time mothers planning a birth in an obstetric unit – although poor outcomes were still uncommon in both settings.

There was no increased risk for second and subsequent babies in planned home births.

There was no increase in risk of poor outcomes for babies for mothers planning to give birth in a midwifery unit, whether they were first or subsequent births.

All mothers planning to give birth at home or in a midwifery unit had substantially fewer interventions compared to those planning births in obstetric units.  

The researchers say the guidance given to women in planning where they want to give birth can now be updated to take account of the study findings.

The Birthplace study was carried out at Oxford University and led by co-investigators from Oxford, UCL (University College London), King’s College London, City University London, NCT, the UK’s largest charity for parents, and the Royal College of Midwives.

For more information about King’s, see our ‘King’s in Brief’ page.

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