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Midwife-led units ‘safer’ than hospitals for low risk birth

 
16/12/2014 | By Freedom Health Insurance
Women with a low risk of complications should be encouraged to give birth at midwife-led units or at home if that is their preference, rather than traditional labour wards, says the National Institute for Health and Care Excellence (NICE) (1).

According to new guidance from NICE, evidence shows that home births or midwife-led centres can be better for mothers and are often as safe for babies as obstetric units in hospitals. This is because the rate of interventions is lower in these units and the outcome for the baby is no different compared to a hospital (1).

There are about 700,000 babies born each year in England and Wales and 9 out of 10 are delivered in a doctor-led obstetric unit (2). However, NICE states that 45% of these pregnancies have a low risk of complications and mothers may be better giving birth in an environment in which they feel most comfortable says NICE’s clinical practice director, Professor Mark Baker (1).

Factors that could increase the risk of complications during birth include complications from previous births, being over the age of 35, having high blood pressure, being overweight or obese and bleeding after 24 weeks of pregnancy (1).

The higher rate of interventions in hospitals is not clearly understood but it might be because of a combination of mothers being more comfortable with midwives they have met before and being in a familiar environment. There is also a concern that some doctors might be too predisposed to using clinical interventions (2). 

The advisory body says that it is important to offer women the options.  Susan Bewley, Professor of Complex Obstetrics at King’s College London supports this: “Giving birth is a highly personal experience and there is no ‘one size fits all’ model that suits all women. What’s important is that women and their families are given the most-up-to-date information based on the best available evidence so that they can make an informed decision about where the mother gives birth to her child” (1).

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References
1. Tanday, S., 2014. Midwife-led units safest for straightforward births, NICE, 3rd December. Available here
2. Gallagher, J., 2014. Home birth ‘could be best for many mothers’, BBC News, 3rd December. Available here.