Britain’s Royal College of Obstetricians and Gynecologists (RCOG) recently declared that too many women are giving birth in hospitals. Fewer than 10% of the U.K.’s women give birth at home or in a midwife-led clinic, a practice which RCOG President Dr. Anthony Falconer said was “not acceptable, nor sustainable.” In a report, the RCOG recommended that the National Health Service invest in more facilities led by midwives, and encourage only women with complications to give birth in hospitals.
The report follows on the heels of an astounding increase in the number of home births in the United States. But although the American College of Obstetricians and Gynecologists (ACOG) is still quick to point out that giving birth at home, particularly in a pregnancy with complications, can be quite unsafe, the RCOG countered by saying that hospital births were not the “safer option.”
Falconer explained, “There is a perception among patients that they still see the hospital birth as the safer option. The use of some of these midwife-led units is not as great as it should be. These places are very safe and appropriate to have babies. Roughly a third of women need a doctor, roughly a third need midwives and roughly a third might need both.”
A push to encourage government investment in home births and birth clinics could be a serious boon for midwives, who are often pitted against the more powerful traditional medical establishment and painted as the “unsafe” choice. It could also save the government money, since home births cost a third as much as hospital births. And, most importantly, increasing women’s options and educating them about these options increases the likelihood that women will receive the care they need.
Whether this progressive view will have much traction in Britain, much less move across the Atlantic to the United States, is anyone’s guess. Only a few U.S. states require insurers to cover home birth, which means that although home birth is a cheaper option, most people who want it have to pay out of pocket. This probably contributes to the niche market for home birth, which is overwhelmingly concentrated among educated white women. Pressure from institutions like the RCOG could encourage the government to subsidize more midwives’ activities, which, as the RCOG’s report shows, could only be a good thing.
Photo from o5com via flickr.