Risks for these ‘low risk’ women were low in all settings, with over
990 babies in every 1000 born healthy and well. For ‘low risk’ women
who have previously had a baby, there was no difference in the risk of
an adverse outcome for the baby (a serious or potentially serious
complication, including a small number of deaths), between those
planning to have their baby in a hospital obstetric unit and those
planning a home birth.
For ‘low-risk’ first-time mothers there was a difference for those
planning to have their baby in hospital and those planning a home
birth. In round numbers, the risk of an adverse outcome for the
baby was greater for those planning a home birth:
• 1 in 190 - for women planning to have their baby in hospital
• 1 in 110 - for women planning a home birth.
So, while overall, the chance of an adverse outcome was small
in these ‘low risk’ mothers wherever the birth was planned.
However, the chance of an adverse outcome was about 1.75
times greater for first-time mothers who were planning for a
home birth at the start of their care in labour. (Actual numbers
(to nearest whole number): planned OU births 1 in 189 vs. planned
home births 1 in 108.) This can also be expressed another way.
‘In the subgroup analysis stratified by parity, there was an
Source: Birthplace in England Collaborative Group. Perinatal
‘In the subgroup analysis stratified by parity, there was an increased incidence of the primary outcome for nulliparous women in the planned home birth group (weighted incidence 9.3 per 1000 births, 95% confidence interval 6.5 to 13.1) compared with the obstetric unit group (weighted incidence 5.3, 3.9 to 7.3).’ Source: Birthplace in England Collaborative Group. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study BMJ 2011;343:d7400.