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First-time home births carry 'increased risks'

Babies born to first-time mothers face an increased risk of complications if they are born at home.

However, the chance of harm to the baby is relatively small - standing at less than 1% - research shows.

A complication rate of 9.3 per 1000 planned home births was found compared with 5.3 per 1000 births for births in hospital.

The Birthplace study, which analysed almost 65,000 births in the UK, found there to be no increased risk for babies born at home to mothers in their second pregnancy.

In comparing the safety of births planned in four settings: home, freestanding midwifery units (FMUs), alongside midwifery units (AMUs) and obstetric units (OUs), overall the study found childbirth to be “very safe”.

There is a “fairly high probability” of 45% that first-time mothers planning a home birth would be transferred to an obstetric unit during labour or immediately after the birth.

This is compared to 36% for planned FMU births and 40% for planned AMU births

For subsequent pregnancies, the transfer rate dropped to 12% for home births.

Women under midwife-led care were “significantly” more likely to opt for a natural birth than those in OUs.

Research also found there were no significant differences in complication rates between midwifery-led and doctor-led care.

“The Royal College of Obstetricians & Gynaecologists (RCOG) has always supported appropriately selected home birth but this study has shown that first-time mothers wishing to deliver at home have an increased risk of poor outcomes for their babies thus raising questions about the right birth location for this group of women,” said Dr Tony Falconer, President of the RCOG.

"In addition, the high transfer rate from FMU and AMUs for first-time mothers pose serious logistical problems.

"There is a need for further work on the adverse outcomes of home birth for first-time mothers and to examine why intervention rates are higher in obstetric units. Better information systems in maternity, through the implementation of the national maternity data set would be beneficial for delivering high quality care."