Previous research shows that women may want to plan for home birth
or birth in a maternity unit run by midwives (a ‘birth centre’) because:

• it is a less clinical environment with more comfort and privacy

• there is a focus on supporting women and keeping birth
‘normal’ – avoiding interventions where possible

• they are less likely to experience a range of medical
procedures which some people prefer to avoid

• mothers and babies are less likely to be separated after
birth allowing skin-to-skin care and easier breastfeeding.

‘Out of hospital’ birth is associated with a variety of potential
benefits, mainly due to the reduced chance of having an operative
birth (forceps or caesarean birth). These include:

• less postnatal pain,

• faster recovery after the birth,

• less likelihood of mothers being separated from their baby
(babies often go into the nursery for a period of observation
following a forceps or caesarean birth),

• more options in a subsequent pregnancy
(women with a scar from a caesarean will be considered higher risk),

• after a caesarean birth, women’s fertility may also be slightly
reduced3 and unexplained stillbirth may increase,4 though some
research shows no difference in having a second viable pregnancy
after a caesarean in a first pregnancy5,6 and further research is
needed.4,6

The Birthplace study shows that women who plan to give birth
at home or in a birth centre are:

- significantly less likely to have episiotomy, forceps, ventouse
or caesarean section.*

- significantly more likely to have a ‘normal birth’.*

Source: Birthplace Research Programme - Background Q&A

A Normal birth – ‘Normal birth’ is defined as occurring when labour
starts spontaneously, there is no use of epidural, spinal or general
anaesthetic and the baby is born without the assistance of episiotomy,
ventouse, forceps or caesarean.1,2

*Some women who plan a home birth or to use a birth centre need to
transfer to hospital care, and they may have an assisted birth, but for
the whole group of women planning care out of hospital intervention
rates are lower.

References

1. Werkmeister G, Jokinen M, Mahmood T, et al. Making normal labour
and birth a reality - developing a multi-disciplinary consensus.
Midwifery 2008;24(3):256-9.

2. Maternity Care Working Party. Making normal birth a reality.
Consensus statement from the Maternity Care Working Party: our
shared views about the need to recognise, facilitate and audit
normal birth. National Childbirth Trust; Royal College of Midwives;
Royal College of Obstetricians and Gynaecologists; 2007.
Available from: http://www.nct.org.uk/professional/research/
pregnancy-birth-and-postnatal-care/birth/normal-birth

3. Murphy DJ, Stirrat GM, Heron J, et al. The relationship between
Caesarean section and subfertility in a population-based sample
of 14,541 pregnancies. Hum Reprod. 2002;17(4):1914-7.

4. Gray R, Quigley M, Hockley C, et al. Caesarean delivery and
risk of stillbirth in subsequent pregnancy: a retrospective cohort
study in an English population. BJOG 2007;114(3):264-70.

5. Smith GC, Wood AM, Pell JP, et al. First cesarean birth and
subsequent fertility. Fertility and Sterility 2006;85(1):90-5.

6. Oral E, Elter K. The impact of cesarean birth on
subsequent fertility. Curr.Opin.Obstet Gynecol 2007;19(3):238-43.