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NICE guidelines encouraging women to undergo home births are a cause for concern

4th December 2014

The National Institute for Health and Care Excellence (NICE) is encouraging expectant mothers experiencing a straight-forward pregnancy to choose a home or midwife-led centre birth, but could be placing women and their babies at risk warns Moore Blatch. 

Under the new guidelines, women will have a choice of giving birth either at; home, an obstetric unit at a hospital, midwife unit next to a hospital or a midwife unit in the community.

In order for this to work practically and mothers to have access to this range of choice, the Royal College of Midwives has called on more midwife-led units to be introdued across the country.

At present there are approximately 700,000 babies born each year across the UK, with the majority, nine out of 10 being born in doctor-led obstetric units in hospital. Under the new guidelines, 45% of women with extremely low risk of complications are seen as better off giving birth in another setting other than a hospital. 

Moore Blatch clinical negligence partner, Vicky Hydon says that the broad-brush advice provided by NICE is potentially dangerous and could lead to an increase in tragic cases of loss or serious injury. 

Vicky, who has dealt with a variety of circumstances where mothers and their babies have been injured during or immediately after the birthing process, says that many of these cases involve women that have been categorised as low-risk, which can lead to a false sense of security.

Vicky comments: “When problems occur during a pregnancy, our experience is that every minute counts and having immediate access to emergency care can make a significant difference to the well-being of the mother and child. Any delay or wait in transferring a mother to a labour ward could have serious long term consequences.

“Whilst providing women with birthing choices is desirable, this should not override basic safety needs.”

Previously NICE had cautioned women against home births and deliveries in midwife-led units. But following in-depth studies into the safety of different maternity settings, which investigated births across England, midwife-led care was found to be as safe as doctor-led hospital care. With reports suggesting that there were higher rates of interventions in hospital.

Whilst home births were associated with a higher risk for first time mothers, overall they were found to be as safe as other settings for low-risk pregnancies where a woman had at least one child already.

Across the UK there are approximately 80 midwife-led units based on hospital sites and 60 located elsewhere, with one midwife per woman in labour recommended.

“For any woman considering pursuing a home birth, we would encourage you to discuss and have in place emergency back-up options should you require these. For those considering a midwife led unit, we would recommend choosing one based on or next to a hospital site. This will help give you peace of mind and allow you to concentrate on the birth, which is often a time of great joy for many couples,” concludes Vicky.


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