Home Birth
The Birthplace Study – Homebirths Not As Safe For First Time Moms
The BMJ – http://www.bmj.com/content/343/bmj.d7400. today 25/11/2011 published an important study about 64,500 expectant mothers with the intention of assessing their pregnancy outcomes as related to the place of birth.
Thankfully it is very safe to deliver in any of the 4 birth places assessed; including at home, in Midwifery run units usually away from Obstetric hospitals, in units run by midwives but attached to hospitals and in the standard specialist hospital unitsunits.
Pregnant women have more choice
The study women were all low risk without identifiable potential problems in their current pregnancy or previous birth. A number of outcomes were recorded as a a method of determining bad or dangerous outcomes. These events included baby and mother illnesses, baby injury of death, lung problems particularly related to aspiration of meconium (baby stool passed in the womb).
The results of the study suggest no significant differences concerning the occurrence of untoward events between the places of birth, except among first-time mums who were more than twice as likely to have problems during deliveries at home.
Overall this was a reassuring message on childbirth among women in England and strengthens the view pregnant women should be given options of where to deliver. More importantly for first time pregnant women, the study result offer them a basis for dialogue between them and their midwives. It should not be a reason to deny them home births but be a basis for full discussion as deemed safe.
RCOG
In response to the study conclusions, the Royal College of Obstetricians & Gynaecologists sounded a positive though cautious note:
“However, based on the evidence presented by Birthplace, we know that 45% of primagravid women having home births require transfer to hospital. This rate is high. The incidence of adverse perinatal outcome for first-time mothers is also significantly higher for those planning home births. Therefore, it is appropriate that this group of women should be delivered within either an adjacent midwifery unit or an obstetric unit. Similarly, the transfer rate for primagravid women from freestanding units is high suggesting that this is not ideal even when outcomes are similar. Multigravid women fare better and the incidence of transfer from home or midwifery unit to hospital is much lower. “
