Women who have low-risk pregnancies should be able to choose where they give birth -- hospital, home or midwifery units -- researchers in Britain say. Professor Peter Brocklehurst of the University of Oxford for the Birthplace in England Collaborative Group compared perinatal outcomes and interventions. A total of 64,538 single, full term infants born to women with low-risk pregnancies were involved in the study. the mothers' age, ethnic group, body mass index and deprivation score were taken into account. Serious adverse outcomes included: Stillbirth after start of labor, early neonatal death, brain injury, feces in the lungs and injuries to the upper arm or shoulder during birth. The study, published in the British Medical Journal, found overall, the rate of adverse outcomes was low in all birth settings at 4.3 per 1,000 births and there were no significant differences in the odds of an adverse outcome for any of the non-obstetric unit settings compared with obstetric units. However, for women giving birth for the first time, the risk of an adverse outcome was more than twice as high -- 9.3 per 1,000 births for planned home births compared with obstetric units. The same did not hold true, though, for either midwifery unit settings. In contrast, for women who had given birth before there were no significant differences in the rate of adverse outcomes among birth settings.
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