Last month, Britain’s National Institute for Health and Care Excellence released new guidelines encouraging women with uncomplicated pregnancies – roughly 45% of all pregnancies in their estimation – to have their babies at home or in a birth center instead of a hospital. This new advice marks a significant shift in the NIH’s position on birth location, which as recently as 2007, advised caution about home birth. The change came, in part, from the findings from a 2011 Oxford University study that found that low risk mums-to-be birthing in a hospital had a higher risk of cesarean delivery, infection, and episiotomies. The study also noted that hospital-based births are more likely to include epidural anesthesia, which was found to increase the risk of protracted birth and the use of forceps. The overall risk of serious complications and death for infants was found to be the same across hospital, birth center, and home births for multipara mothers. First-time mothers birthing at home have a slightly increased risk for such complications.
Going forward, pregnant women in the UK expecting their first baby will be encouraged to seek care from a midwife-led delivery unit either based in a hospital or out-of-hospital. Those having their second or subsequent baby and considered low-risk will receive even greater encouragement to delivery at home. The guidelines recommend informing multipara mothers that a home birth would be just as safe for their baby and an even safer option for them than delivering at a hospital. NIH’s announcement about the new guidelines says, “Healthcare professionals should inform women of the options available to them and advise that they have the freedom to choose where they give birth.”
Read the full announcement from NIH here.
Additional coverage of the guidelines can be found at The New York Times and The Guardian.