Home births not NICE

Royal College of Midwives

The National Institute of Clinical Excellence (NICE) has been studying the vexed issue of the safety of home births in the UK. Their preliminary conclusions are restrained and sensible:

"In relation to women's and babies' outcomes for home births, there is a lack of good quality evidence. Limited quality evidence shows less intervention and higher maternal satisfaction with a planned home birth compared to a planned birth in hospital.

"Evidence of overall perinatal mortality is ambiguous. However, there is evidence that a booked home birth has a higher intrapartum-related perinatal mortality [death around the time of birth] than a booked hospital birth." (Report here)

Until further and better information is available, the rational approach must be to counsel caution and to advise woman that a home birth may subject their baby to greater risks.

It would be too much to expect a rational approach from the Royal College of Midwives. The appalling Louise Silverton is on the rampage again. We have met Louise before. Remember, she is the one who does not like women being able to choose to have an epidural.

Science, and the analysis of data, is not one of Louise’s strong points.

Louise Silverton … took issue with the idea that it was safer to give birth in a hospital. She said home birth was a better option for the 60%-70% of women who experienced no complications during labour.

"Remember that the woman is in fact running a marathon when she's in labour. She needs to be fed, needs to be able to move, and needs to be in control of the situation."

"In our hospitals today which are very medicalised - many women don't find that a conducive environment for labour." (BBC)

(The full interview on Radio 4 this morning can be heard here on the Today programme "listen again" web site - Friday 23 June, 07.32 a.m.)

She does not mention that you can only identify the women who have not had complications retrospectively. Maybe she does not know that. Women in labour are not “in fact” (sic) running a marathon. They are having a baby. Presumably by using this ludicrous analogy Louise is proposing to give women in labour a “carb load”. A large plate of Spag Bol maybe?

Glad that she has noticed that hospitals are “medicalised”. They will have the equipment to resuscitate the mother when she vomits and inhales the aforementioned “carbs”.

The government is enthusiastic about home births. It asked NICE to report on them. NICE urges caution.

Why do the Royal College of Midwives not accept this? Why can you never talk a midwife out of home deliveries, even if the baby dies (as here)?

Because the midwives know better. Midwifes always know better. They know better than the government. They know better than NICE. They know better than doctors. They know better than the majority of women who have babies. They do not need science. They do not need research. They just "know".

Have a look at these internet sites from independent, “radical” midwives. They even seem to contemplate and support home deliveries for babies known to be breech, and even for twins. (see here).

Is there a single doctor out there who would support such views?