Home births are safer in some cases, British health authorities say. Photo: Stocksy
British health authorities will now tell expectant mothers that it is safer to give birth at home in some cases, in a move that could lead to hundreds of thousands of babies born without a doctor's involvement.
The National Institute for Health and Care Excellence has updated its advice to women, telling them that if they have an uncomplicated pregnancy and have already had one child, they should consider giving birth at home with a midwife.
First-time mothers will be told they are better off in a midwife-led clinic than hospital, but if they give birth at home there is a "small increase" in the risk of something going wrong.
The decision has been welcomed by midwives in Australia as a decision that puts evidence above politics, but criticised by doctors who say it will put women and babies at risk.
The institute's clinical practice director, Mark Baker, said most women were healthy and had straightforward pregnancies and births.
"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," he said. "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."
The institute estimates about 315,000 babies born each year whose mothers could be eligible for a home birth.
Susan Bewley, a professor of complex obstetrics, who chaired the group that updated the guidelines, said not all women would choose that option.
"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.
The president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, Michael Permezel, said the group strongly disagreed with the suggestion it was safer for women to have their babies at home.
The biggest trial of home births had shown a threefold increased risk of death for the baby, but small trials of home births often did not show the safety risk because death or serious injury was still relatively rare, with about one in 1000 babies dying, he said.
"We know that most women want to do the absolutely safest thing, and even a risk of one in 1000 is absolutely too high for the vast majority," he said. However, it should not be ruled out for the "small group" of women who were willing to accept that risk and strongly preferred to be at home.
The UK's Royal College of Obstetricians and Gynaecologists has welcomed the guidelines, but warned women to consider how far away they are from emergency care if a problem was to arise.
The advice has also been criticised by a UK group representing women who have suffered birth trauma.
Hannah Dahlen, the national media spokeswoman for the Australian College of Midwives, said the UK was basing its guidelines on the highest level of scientific evidence - unlike Australia, where politics, bias and vested interest ruled.
She said it was ironic that Australian midwives were concerned, at the same time, that an exemption that allowed them to attend home births without expensive public indemnity insurance was due to expire mid-next year.
Without the exemption, they could not afford to attend home births, and they fear some women will be pushed into giving birth with no support at all.
"We still have no formal information from our health minister as to whether it will be illegal for midwives to attend home births after June 30, 2015," she said. "Women are now pregnant and due to give birth in July. Should they plan to move to the UK?"
However, a spokesman for Health Minister Peter Dutton told Fairfax Media it had already been decided the exemption would be extended until the end of 2015.