Choice of place of birth

We believe that women should be able to choose to give birth in either a consultant-led unit, a midwife-led unit or at home. The NCT has produced a critique of the Wax et al article recently published in The American Journal of Obstetrics and Gynaecology on the safety of home birth - click here to download the critique (PDF 42 KB)

The NCT has also produced a review on the safety of planned home birth and a discussion on birth centre care. 

In April 2007, the government published Maternity matters, applicable to England, which made a number of choice guarantees to be delivered to women by the end of 2009. One of these guarantees was:

‘Depending on their circumstances, women and their partners will be able to choose between three different options. These are:

• a home birth
• birth in a local facility, including a hospital, under the care of a midwife
• birth in a hospital supported by a local maternity care team including midwives, anesthetists and consultant obstetricians.’

This policy is supported by the NICE Intrapartum care guidance, which states that women should be offered the choice of planning birth at home, in a midwifery unit or in an obstetric unit, and be given information to enable her to make a well informed choice. 

NCT research suggests that in 2008-9, over 95% of women did not have reasonable access to the three options guaranteed by Maternity Matters. This forms the basis of our Location, location, location campaign, which calls for a guarantee of choice of place of birth to be guaranteed and delivered throughout the UK.

The Welsh government has shown a commitment to home birth, rather than choice more generally. There was a 10% target for home birth, and their National service framework (NSF) confirmed their commitment to home birth stating “…women who choose home delivery as their birth option are supported in that choice, appropriate to the level of clinical risk.” Unfortunately this target was missed, though Wales maintains the highest home birth rate of the four countries of the UK.

In Scotland, choice of place of birth is encouraged, but not guaranteed under A framework for maternity services, published in 2001. Keeping Childbirth Natural and Dynamic is also supportive of choice.

There is also a range of relevant NCT reviews of evidence on this topic, first published in the NCT’s quarterly continuing professional development journal New Digest