The Guardian view on home births: life’s initial journey

http://www.theguardian.com/commentisfree/2014/dec/23/guardian-view-on-home-births-initial-journey

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Home births are better for mothers and safer for babies – this is the latest advice from the National Institute for Health and Care Excellence. According to Nice, nearly half of the 700,000 babies that are born in England and Wales every year would be better off being born at home rather than in hospital. Professor Susan Bewley from Kings College London’s obstetrics department insists that “midwifery-led settings have better outcomes for mothers than the traditional obstetric units and labour wards”. Particularly significant to Nice’s thought process is the suggestion that home births offer a more conducive, less stressful environment than a noisy hospital ward, where infection is often more difficult to contain and where stretched doctors are all too keen on epidurals and forceps. Yes, there are those who argue that the whole scented candles and birthing pool ideal is really just a cover for the fact that home births are almost £500 cheaper than their hospital equivalents, but allowing women greater choice on where and how they give birth is obviously welcome.

Challenging the presumption that doctor-led obstetric units are the best places for the birth of a child will not be straightforward – 90% of mothers currently choose this option, no doubt because they feel safer amid the reassuring presence of doctors and technology. Hospital births are still advised for women over 35 or those with medical conditions that increase the risk of complications. Royal babies, such as the Duchess of Cambridge’s second child, would presumably be perfect candidates for a home birth at Kensington Palace. Indeed, the present Queen had all of her four children at home. So there is considerable royal precedent. These new guidelines from Nice have stimulated debate abroad as well. Mothers giving birth in Israel, for example, are currently encouraged to do so in hospital, via a 12,000-shekel (£2,000) “hospitalisation grant” paid directly to the infirmary. As a consequence, home-birthing in Israel continues to be done on the cheap. Such an abiding and stable state of affairs is now being challenged – something that is long overdue.