Thursday, December 1, 2011

Safety of home birth - the UK Birthplace study

Birthplace study 

Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: The Birthplace in England national prospective cohort study. 

This new cohort study from the UK reports on birth outcomes for healthy women with low risk pregnancies.

As with all research, statistics can be interpreted differently by different people.  In this post I want to give a general overview of the research, and provide links for those who are interested in reading more.

The first point to note is that the title 'Birthplace' may be misleading.  The outcome data was sorted according to PLANNED [not actual] place of birth.

Readers may remember a study from South Australia (Kennare et al 2010) which received considerable press coverage as it claimed huge increases in adverse outcomes for planned homebirths. For more comment and links relating to that study, click here.

Although there are major differences between planned homebirth in the UK and planned homebirth in Australia, valuable lessons can be learned when we review and critically consider the meaning of results of research.  

Births at home or in hospital: risks explained is an article at the NHS Choices: your health your choices website.  The explanations given are well considered: compare with the titles and subsequent content of newspaper articles listed and linked at the end of the piece.

Links to the headlines

First-time mothers warned over home birth risks. The Daily Telegraph, November 25 2011
Home births three times more risky than hospital, says study. Metro, November 25 2011
Women with low-risk pregnancies 'should have birth choices'. The Guardian, November 25 2011
First-time mothers who opt for home birth face triple the risk of death or brain damage in child. Daily Mail, November 25 2011
Home as safe as hospital for second births. The Independent, November 25 2011
Home birth risks up for new mums. The Sun, November 25 2011

Another commentary worth reading is at the Having a baby  blog.  The writer Marina Colville concludes:
This study supports government policy to offer choice in place of birth to all women.  However, there remains a severe lack of viable community midwifery services with associated expertise which means most women do not have a realistic choice of where they give birth despite a potential claim to the contrary by a range of Trusts.  This issue should be addressed by NHS managers who have so far largely not implemented this long standing government policy particularly in the face of extensive evidence from this study showing the cost-effectiveness of it.
Make no mistake, any attempt to change the maternity service following this study will be as tortuous as the previous years of inaction but this study is vital fuel for the fire making the case for better birth experiences for women and babies.

Your comments are welcome.
ps: for Sarah Buckley's comments on the question 'Is homebirth safe?' and links to her work, go to

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