Researchers from the University of Oxford compared the outcomes of children born to more than 64,000 women with low risk pregnancies across England just before, during, or shortly after birth, to the interventions used during labour.
The landmark Birthplace study - the first to study where women planned to give birth - found that overall there were no differences in outcomes for babies between any of the planned places of birth.
The women involved in the study either gave birth at home, in standalone midwifery units, midwife-led-units within a hospital, and maternity units.
The findings reveal that overall the rate of adverse outcomes was low in all birth settings. Serious adverse outcomes were considered as still birth, early neonatal death and a range of conditions associated with trauma at birth, or teh baby becoming distressed or being deprived of oxygen during labour.
Among almost 65,000 low risk births, there were 250 births where the baby had a poor outcome.
However, women who give birth for the first time at home have an increased risk of poor outcomes: 9.3 per 1,000 births compared with 5.3 per 1,000 births in obstetric units.
In contrast, for women who had given birth before, there were no significant differences in the rate of adverse outcomes, no matter where they gave birth.
Professor Peter Brocklehurst from the University of Oxford, who led the study, said, ‘These results should reassure pregnant women planning their birth that they can make informed decisions about where they'd most like the birth to happen, knowing that giving birth in England is generally very safe. There is an increase in risk for first-time mums planning home births, but poor outcomes for the baby are still uncommon.'
The study echoes a report from the Royal College of Obstetricians and Gynaecologist in July that called for women with low-risk pregnancies to give birth at home or in a midwifery-led unit, with the option of a hospital birth still available to them if they choose, to relieve the pressure faced by hospitals.
Mary Newburn, head of research and information at NCT, said, ‘NCT supports women and their partners to make decisions that feel right for them about where to plan to have their baby.
'They need reliable, up-to-date information that addresses their questions and concerns, in order to make informed decisions. The birthplace study adds significantly to what we know about options for birth.
‘NCT believes all pregnant women should have access to the full range of birth options: a home birth service sufficient to meet demand, a birth centre – either freestanding or alongside an obstetric labour ward – and the option of birth in hospital. The new evidence would support more birth centres being opened, creating positive choices for many more women.’
The 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’, is published in the BMJ journal.