Hum Posted November 25, 2011 Share Posted November 25, 2011 A new study in England shows little difference in complications among the babies of women with low-risk pregnancies who delivered in hospitals versus those who gave birth with midwives at home or in birthing centers. Based on the findings, researchers said women with uncomplicated pregnancies in England should be able to choose where they want to give birth ? and one expert said about half of all pregnant women here could potentially safely give birth outside a hospital. But they sounded a note of caution for first-time mothers and their infants, who may face a higher risk if they choose a home birth. "I would never say women should give birth in a particular place, but hope this gives women more information to make an informed choice," said Dr. Peter Brocklehurst, director of the Institute for Women's Health at University College Hospital in London, one of the paper's lead authors. He conducted the research while at Oxford University. "Birth isn't an abnormal process, it's a physiological process," he said. "And if your pregnancy and labor is not complicated, then you don't need a high level of specific expertise." Brocklehurst added that about 50 percent of pregnant women in England ? those who are low-risk ? should be able to choose where to have their baby. More than 90 percent of pregnant women in England now give birth in a hospital. Some officials say the new study should prompt women to consider alternatives. more Link to comment Share on other sites More sharing options...
DocM Posted November 25, 2011 Share Posted November 25, 2011 Of course the problem is that "low risk" births can go "high risk" in a heartbeat, even with an experienced nurse-midwife. A solution in many parts of the US are reduced cost Birthing Centers - which are in or adjacent to hospitals so emergency care & surgical facilities is immediately available but are more akin to a home birth otherwise. The family is in the room, which is also the labor, delivery and post - birth space and where the baby stays until discharge if all goes well. While the room and bed are conventional looking, the bed has a headboard etc., they can transform into other form factors in no time. The furnishing includes conventional furnishings and a couch, as well as a fold-out for sleeping over kin like Dad. Oxygen, suction etc. are behind hidden panels and high intensity lights are built-in and recessed. Essentially - it looks as much like a normal bedroom as possible, but larger. A lot of these are going in around here and they're very well received. Our youngest was born in one 13 years ago and it was great. Cost wise it saves thousands of $$ per birth because it eliminates a lot of infrastructure and staff. Link to comment Share on other sites More sharing options...
jakem1 Posted November 25, 2011 Share Posted November 25, 2011 Birth centres are also available in hospitals in the UK. Here's some more detail about the findings of the study: Professor Peter Brocklehurst of the University of Oxford and colleagues in the Birthplace in England Collaborative group found that adverse outcomes for the baby ? including stillbirth, death soon after birth and oxygen deprivation whichthat could cause brain damage ? were rare in women who had low-risk pregnancies. Overall, they happened in 4.3 births per 1,000 and there were no significant differences between hospital obstetric units and elsewhere. There was, however, an increase in the risk of an adverse outcome for babies of first-time mothers at home ? 9.3 per 1,000 births, compared with 5.3 in hospital and 4.5 in a dedicated birth centre. Taking out those women who had any sort of complication at the start of labour, the gap was slightly bigger because hospital outcomes were better: 9.5 per 1,000 at home compared with 3.5 in hospital compared with 9.5 per 1000 at home, which is an increase of nearly 3%. The slightly worse outcomes at home for first-timers are unexplained. "I don't know why. We don't know which aspects of the care or the site contributed to this," said Brocklehurst. It could be to do with the sort of women who chose home birth, who tended to be white, slightly older, better educated and live in more affluent areas, the midwife's experience, problems in transferring to hospital in an emergency or something else entirely. More work would be needed to establish what was happening. First-time mothers who started at home were much more likely to be transferred to hospital ? 45% were moved, compared with less than 12% of women who had given birth before. Usually this was because labour was not progressing or an epidural was needed. The risks for the baby dropped dramatically for women having their second or subsequent child, to 2.3 per 1,000 at home, 2.7 in a midwifery unit and 3.3 in hospital. http://www.guardian.co.uk/lifeandstyle/2011/nov/25/low-risk-pregnancies-birth-choices As you can see, for second and subsequent children the risks for home births are about the same as for hospital births. Link to comment Share on other sites More sharing options...
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