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Home birth guidelines

The BBC News this morning had considerable coverage of the latest National Institutes of Clinical Excellence (NICE) draft guidelines regarding home births. NICE is the advisory body that establishes “best practice” guidelines for the NHS and they have made a number of recommendations regarding aspects of childbirth and its management.

In their view, women should have more choice regarding the place of birth and home births should be more widely supported. Although Government policy supports home birth, only 2% of women in the UK choose this option, although this figure varies widely across the country - some areas have 12% and there are pockets where 20% choose birth at home.

Beverley Beech, Chair of AIMS was interviewed and stated that choice was a myth and that women were often unable to get a home birth due to local hospital policy. She also said that the practice of sending two midwives to a home birth was unnecessary and not supported by research. She claimed that this practice had been established when it was discovered that home births were cheaper than hospital births, so two midwives were to attend at home to keep the costs artificially high. This was something I had not heard before - I have often questioned the necessity for two midwives at a home birth as it certainly adds to the costs.

The shortage of midwives was raised with the Obstetrician and NICE representative who were interviewed, as well as the old hoary arguments about safety of home births. The Obstetrician was from University College Hospital said he thought that their “home from home” centre was the best compromise (but women who want a home birth want to be at home, not in a birth centre).

Whilst stating that birth at home resulted in less intervention in birth, the safety issue is still unresolved, according to the NICE spokesperson, and they will be “keeping an eye on it”. Given the massive shortage of midwives and the chronic low morale in the UK maternity services, it will take more than these new draft guidelines to turn things around. Even with the very public support for home birth at all levels of Government, they still can’t get their rates up, possibly because of the fear factor in both women and midwives. Women in the country have simply been scared off.

If you want to read about these draft NICE guidelines, which will be finalised next year, you can view them here.

Posted by andrea at June 23, 2006 05:43 PM