New guidelines will make you think twice about where you give birth... Every pregnant woman carefully considers where they have their baby and this week, the National Institute for Health and Care Excellence (NICE) have released new evidence that shows hospital births aren't necessarily the right choice for everyone. Here, we have a post by Tracey Cooper, Consultant Midwife for Lancashire Teaching Hospitals NHS Trust who helped to develop the updated recommendations for NICE. Hundreds of thousands of babies are born each year in England and Wales: last year, midwives helped to deliver nearly 700,000 newborns. Each birth is a cause for celebration and nothing makes a midwife happier than helping to bring a new life into the world, delivering a baby into the arms of its mother. At the moment, roughly 9 out of 10 babies are born in traditional labour wards, but not everyone will need to give birth in hospital. Evidence assessed by the National Institute for Health and Care Excellence (NICE) shows that midwife-led birth units are actually a safer option for pregnant women experiencing a straightforward (low risk) pregnancy. Not only do women experience less medical intervention during labour, but the risk of their babies being born with a serious medical complication is no higher than in hospital. And for low risk women who have already had at least one child previously, home birth is equally as safe as midwife-led units for both mother and baby. NICE have updated their official guidance to the NHS to give women greater freedom to choose where they give birth. They say that women should be given this information to help them think about where they would most like to give birth, but that the final decision should be made by them and supported by healthcare professionals. This is a positive step forward in the care of healthy women with a straightforward pregnancy. Before now, there simply wasn’t enough evidence to know for sure how midwife-led birth units compared with traditional hospital obstetric units. Now there is. Where and how a woman gives birth to her baby can be hugely important to her. Although women with complicated pregnancies will still need a doctor, there is no reason why women at low risk of complications during labour should not have their baby in an environment in which they feel most comfortable. This isn’t about saving the NHS money. This is about the safety of women and their babies. As Elizabeth Duff from the NCT says: “[Midwife-led units or home birth] are safe for most women and can offer benefits such as care from a known midwife and less intervention. Health commissioners should now put these guidelines into practice as soon as possible and make home and community birth a real, not just theoretical, option.” The updated NICE guidance is about so much more than just location of birth though. It is a comprehensive document designed to promote the best care, support and information to pregnant women with straightforward pregnancies. For instance, it also advocates one-to-one care for all women during childbirth by a midwife, which is good news. I don’t know a single midwife who wouldn’t want to give a woman her full attention during such a life-changing event. I sincerely believe it will support midwives to focus on caring for women during childbirth and lead to the best outcomes for babies.
Alexandra Phillips

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