Study calls for urgent review of NHS and independent birth care
There is an urgent need to review certain aspects of care for women giving birth using an independent midwife and those using NHS services, concludes a study published on bmj.com today.
Patient choice is a key aspect of government health policy in the UK and hospitals are urged to support low risk women who want to give birth at home.
Currently, around 2.5% of births occur in the home, most with NHS personnel in attendance, but a small number of women opt to employ an independent midwife, a self-employed qualified practitioner working outside the NHS.
Studies have consistently shown that, for low-risk women, giving birth at home is as safe as giving birth in hospital, yet no studies have compared likely outcomes for women using an independent midwife and those using NHS services.
This study shows the difficulties researchers face in trying to compare outcomes between independent midwifery services and NHS care, say experts in an accompanying editorial.
Allison and Brett Shorten from the University of Wollongong and the Informed Health Choices Trust in Australia believe that mainstream maternity services "need to move beyond the rhetoric of policy documents and provide the type of services that women demand."
They conclude: "Health systems will need to cultivate models that foster open referral and consultation between professional groups and most importantly make genuine efforts to include women in decision making. Collaboration within and between disciplines will increase the likelihood of providing higher quality, safe services for women and families."
"I think it's very true that many women could safely birth their babies at home and that independent midwives should be allowed to remain practising in this country because for some women this would be the only option to get the birth they want and deserve" - Jolanda Corbijn, London
"Once again we find that an independent homebirth for NORMAL pregnancy is better than a hospital birth. Your baby will have a higher birth weight, is less likely to be premature and in intensive care. You're more likely to start labour spontaneously and breastfeed, and will use fewer drugs. High-risk women who choose an independent midwife should be allowed to deliver in hospital, it is the policy of not allowing independent midwives access to NHS hospitals that puts these women at risk." - Antony Wright, London