The Birthplace programme has not been able to explore whether there is
any association between the size of either hospital obstetric units or birth
centres and outcomes for women or babies. Nor was it able to explore
whether midwifery or medical staffing levels, seniority or years of experience
affect outcomes. As serious or potentially serious adverse outcomes for women
and babies are rare in a ‘low risk’ population who continue to be assessed as
pregnancy develops, the small numbers make it impossible to drill down to
ask a lot of specific questions. Birthplace looked solely at outcomes by
planned place of birth, and also carried out further analysis by parity (whether
women were first-time mothers or had had a baby before).
The Birthplace mapping study found a large variation between NHS trusts
and between different regions in England in the way maternity services are
configured (some have higher home birth rates, some have both
freestanding and alongside birth centres, and some have no
midwife-led units). It was not possible to link the data collected about the
way services are configured and managed with outcomes for women and babies.