Stillbirth and brain injury risks for 1st-time home births?


The journalist Miriam Stoppard has written of her concerns about the benefits of home birth for 1st-time mothers.

12 years ago one of Ms Stoppard's daughters-in-law opted for a home water birth for her 1st child.

Home Birth for 1st time moms a risk

However, a midwives' advisory panel at the time predicted that the mother might have to go into hospital in order not to risk stillbirth or brain injury in her baby. Ms Stoppard was told that many 1st-time mothers become afraid if labour continues for any length of time, and that many also request extra pain relief.

This scenario proved to be the case with the mother in question, who is typical of many surveyed in an Oxford University study published in the British Medical Journal.

Involving nearly 65,000 women and the largest of its type, the study shows that half are transferred to hospital while in labour, compared to a 3rd from midwifery units.

2nd and 3rd-time mothers who have already had straightforward hospital births after healthy pregnancies are classified as low risk.

Other complications for 1st-time mothers include higher rates of stillbirth after the start of labour, brain injury, infant death within a week of birth, fractures of the upper arm and breathing difficulties, of which there were nearly 10 per 1,000 home births for first-time mothers compared to around 3 per 1,000 births for 1st-time mothers in hospital.

Ms Stoppard writes that a safer option might be a planned delivery in ¬a midwife unit, where any risk of stillbirth or brain injury is more tightly controlled.

Neil Fearn of Simpson Millar LLP said that giving birth is usually perfectly safe. "The concept of 'choices in childbirth', where a woman is entitled to choose how and where to have her baby, is one of Miriam Stoppard's most cherished ideas," said Neil. "But it's vitally important to consider all the current medical thinking on home birth before embarking on what could be a risky procedure."

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