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British advisory on low-risk pregnancies
Home births safer than hospitals
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LONDON --Women with low-risk pregnancies are better off giving birth at home than in a hospital, according guidelines updated in the United Kingdom on Wednesday.

The new recommendations from the National Institute for Health Care and Excellence replaced guidance published in 2007 that said women should be “cautious” about home birth, stating there were no conclusive risk assessments at the time.

“Most women are healthy and have straightforward pregnancies and births,” NICE clinical practice director Mark Baker said in a statement. “Over the years, evidence has emerged which shows that, for this group of women, giving birth in a midwife-led unit instead of a traditional labour ward is a safe option. Research also shows that a home birth is generally safer than hospital for pregnant women at low risk of complications who have given birth before.”

Units led by midwives are preferable because there is a lower rate of intervention and the outcome for the baby is “no different compared with an obstetric unit,” according to NICE. Specifically, the new guidelines state that women who give birth in hospitals are more likely to have instrumental vaginal birth, cesarean section and episiotomy, which are associated with a higher risk of infection.

The institution estimated thousands more women will opt to give birth at home following the new guidelines. In 2013, 2.3 percent of births in England and Wales occurred at home, NICE reported.

The guidelines are intended to inform women as they choose where to give birth, according to King’s College professor Susan Bewley. She chaired the group that developed the recommendations.

“Some women may prefer to have their baby at home or in a midwife-led unit because they are generally safer -- that is their right and they should be supported in that choice. But, if a woman would prefer to have her baby in a hospital because it makes her feel ‘safer’, that is also her right,” she said in a statement. “Giving birth is a highly personal experience and there is no ‘one size fits all’ model that suits all women.”

Unlike the United States, the U.K. has a universal healthcare system paid for by taxes that covers both home and hospital births. As a result, there are no financial incentives for doctors in the U.K. to deliver in a particular setting, Baker told The New York Times. The U.K. system also allows for quick transfers from home to hospital in the event of unexpected complications.