RQIA planning to birth at home in Northern Ireland
Place of birth influences not only the type of birth that women experience, but also the number of interventions that the mother and baby are exposed to. Women who plan to give birth in a midwife-led unit or at home experience fewer interventions than in an obstetric unit, including: amniotomy, augmentation of labour, episiotomy, instrumental vaginal birth and opiate or regional analgesia.
There is also evidence that, for healthy women, outcomes are better for out of hospital birth and this is also true for the babies of multiparous women born at home. Based on the findings of the England Birthplace Study, NICE’s Intrapartum guideline (CG190) recommends that low-risk nulliparous women should be advised that, if they plan birth at home, there is a ‘small increase in the risk of an adverse outcome for the baby’. Findings from other cohort home birth studies have identified adverse perinatal outcomes from home birth as low and not significantly different from other places of birth. The Birthplace in England study supports a policy of offering women with straightforward pregnancies a choice of all four birth settings (home, midwifery-led unit, freestanding unit, and obstetric unit).
This Guidelines for Nurses summary presents an evidence-based guideline to assist women and healthcare professionals in their decision-making when planning birth at home in Northern Ireland.