Newspaper article International New York Times

Britain Urges Giving Birth at Home, Not in a Hospital ; Low-Risk Mothers-to-Be Are Said to Be in Better Hands with Midwives

Newspaper article International New York Times

Britain Urges Giving Birth at Home, Not in a Hospital ; Low-Risk Mothers-to-Be Are Said to Be in Better Hands with Midwives

Article excerpt

Women with uncomplicated pregnancies are better off in the hands of midwives, either at home or in a birth center, according to new guidelines.

Reversing a generation of guidance on childbirth, Britain's national health service has advised healthy women that it is safer to have their babies at home, or in a birth center, than in a hospital.

Women with uncomplicated pregnancies -- about 45 percent of the total -- are better off in the hands of midwives than hospital doctors during birth, according to new guidelines released on Wednesday by the National Institute for Health and Care Excellence. For these low-risk mothers-to-be, giving birth in a traditional maternity ward increases the chances of surgical intervention and therefore infection, the regulator said.

According to a government-financed 2011 study carried out by researchers at Oxford University, hospital births were more likely to end in cesarean sections or involve episiotomies. Women were more likely to be given epidurals, which numb the pain of labor but also increase the risk of a protracted birth that requires forceps and damages the perineum.

The risk of death or serious complications for babies was the same in each setting, with one exception: In the case of first-time mothers, home birth slightly increased that risk. Nine in 1,000 cases would experience serious complications, compared with five in 1,000 for babies born in a hospital.

The findings could affect how hundreds of thousands of British women think about one of the biggest questions facing them. Nine in 10 of the roughly 700,000 babies born annually in England and Wales are delivered in a hospital.

As recently as 2007, the guidelines had advised women to be "cautious" about home births in the absence of conclusive risk assessments.

Dr. Mark Baker, clinical practice director for the health institute, said first-time mothers with low birth risks would now be advised that a midwife-led unit would be particularly suitable for them, while mothers who already have given birth would be told that a home birth would be equally safe for the baby and safer for the mother than a hospital. …

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