Women with uncomplicated pregnancies (roughly 45%) are better off in the hands of midwives than of hospital doctors during birth. This is according to new guidelines by the British National Institute for Health and Care Excellence. The agency has advised healthy women that it is safer to have their babies at home, or in a birth center, than in a hospital. The reason: in a hospital, there is a greater chance of surgical intervention and therefore infection. Hospital birth was also found to increase costs: hospital births $2500, birth center births $2200, and homebirth $1500.
These recommendations “reversed a generation of guidance on childbirth” according to a December 3, 2014, New York Times article: “British Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies.” The Times piece concludes with a quote from the clinical practice director at the British agency: “Yes, [hospital birth] is a very expensive way to deliver healthy babies to healthy women.” He adds: “Saving money is not a crime.” The article notes that “the findings could affect how hundreds of thousands of British women think about one of the biggest questions facing them.”
Comment: Great to see these data jump the Atlantic. The Times article was notable for downplaying the national treasure midwives are considered in the Netherlands. Midwives on bikes, working their own neighborhoods, are the backbone of the best birth outcomes in any Western country. Cost may yet trump the power of the obstetricians in the United States. One day, hopefully, policy makers will understand that the ultimate cost savings will come when more mothers learn that the whole medical apparatus is not a requirement for them to have a baby. Side note: The state of Washington is the closest in the United States to have imagined that the United States should follow a similar evidence-based path. See Homebirth Midwives and the Hospital Goliath: Evidence Builds for Disruptive Innovation, the most commented upon article I have ever written for The Huffington Post. (Thanks to William Wulsin, ND, LAc, MPA, MPH, for the link to the Times piece.)