Home births cheaper than hospital, study suggests

Women who have children already can safely and more cheaply give birth at home instead of in obstetric unit, research finds

Giving birth at home may be a safe and cheaper option for women who already have children, a study suggests.

Oxford University researchers looked at the circumstances of 64,000 births in England between 2008 and 2010. They found that women at low risk of complications could give birth either at home or in a midwifery unit to save the NHS money.

The study looked at the relative costs of healthy births in different settings. It found that a planned birth in an obstetric unit was the most expensive option for mothers who already have children, with a mean cost of £1,142 per woman. A planned home birth was the cheapest at £780.

For women who have not had children before, a planned birth in a midwifery unit would be cheaper than in an obstetric unit, it was suggested.

The researchers found that a planned birth at home for such women was also cost-saving, but was "associated with poorer outcomes for the baby".

Liz Schroeder, a co-author of the study, said: "At the time of the study, only half of the NHS trusts in England provided women with access to a midwifery unit, and occupancy levels were often low.

"The findings of the birthplace study may encourage women – particularly women having a second or subsequent baby – to request an out-of-hospital birth.

"And the potential for cost savings could make offering women more choice an attractive option for the NHS."

The Royal College of Midwives said the research paved the way for changes in maternity services. The deputy general secretary, Louise Silverton, said: "This and other research points out the substantial benefits of midwife-led care: it is better for mothers and babies, it is better for midwives and it is better for the NHS.

"However, we are still seeing 96% of births taking place in hospitals and this underlines the need to make a fundamental change in the way we deliver maternity services in this country.

"The government constantly tells us it wants more for less, and this is a shining example of how that can be delivered."

A Department of Health spokeswoman said: "We welcome this valuable study which shows how we can provide safe and cost-effective maternity services.

"As we modernise the NHS we have made it a priority to offer women choices in where they give birth. We want women to be able to talk through their birth plan with their midwife, to find the best option for them."

The study looked at births in obstetric units, midwifery units located in the same hospital as an obstetric unit, free-standing midwifery units and at home.

It assessed NHS costs associated with the birth, including care during labour, the cost of any stay in hospital, the cost of pain relief and any medical procedures needed in the case of complications.

In planned home and midwifery unit births, it took into account the cost of any clinical intervention needed if mothers and babies were transferred to hospital, but did not include any longer-term costs such as caring for babies who suffer serious injuries during birth.

The National Institute for Clinical Excellence (Nice) has previously said that estimating the cost-effectiveness of places of birth should be a priority area for research.