Nice Suggests More Midwife-Led Home Births

Women who are healthy and experiencing a 'straight forward' (low risk) pregnancy should be encouraged to give birth in a midwife-led unit rather than a traditional labour ward, according to draft proposals from the National Institute for Health and Care Excellence (NICE).

It also provisionally says that a home birth may be just as safe as hospital for low risk pregnant women who have already had at least 1 child, and that midwives should discuss all options with the women in their care. The proposed changes to the institute's guidance could affect hundreds of thousands of births.

NICE currently recommends that women should be given the choice of where they want to give birth, but urges caution if a home birth or delivery in a midwife-led unit is planned. The Institute is now revising its recommendations in light of new evidence. The draft version of these updated guidelines has been published for consultation.

Almost three-quarters of a million (729,000) babies were born in England and Wales during 2012 - a rise of about 20% from 2002.

Christine Carson, clinical guideline programme director for NICE, said: "Since we published our original guidance, more evidence has come to light about the benefits and risks associated with giving birth at home, in an independent or hospital-based midwife-led unit and on a traditional labour ward.

"We now know that these units are as safe as traditional labour wards for all 'low risk' pregnant women and are more likely to result in a better birth experience with less medical intervention. The evidence also highlights that home births are just as safe as other settings for low risk pregnant women who already have at least 1 child, but not for women expecting their first baby. However, every woman should ultimately have the freedom to choose where she wants to give birth and be supported in her choice."


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