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Last Updated: Thursday, 22 June 2006, 23:44 GMT 00:44 UK
Women 'should have labour choice'
The government has promised mothers choice by 2009
Women in England and Wales should be able to choose where they give birth, NHS advisers suggest.

The National Institute for Health and Clinical Excellence proposed women should get a choice of home, hospital or midwife-led units for labour.

The draft plans also said they should get good advice about the risks and benefits of each option.

They say hospital births may be a safer option, but midwives said this was only needed if there were complications.

Remember that the woman is in fact running a marathon when she's in labour
Louise Silverton, of the Royal College of Midwives

And Health Minister Ivan Lewis told the BBC he believed the evidence that hospital was safer than home was "flimsy".

He said: "We believe that we have to trust and respect women, give them the information then allow them to make the best choice for themselves."

The government has promised more choice by 2009, but campaigners say many women are left with little choice in reality.

They blame staff shortages and lack of money.

The proposals by NICE, which will now be consulted on, could take several years to be implemented by the NHS.

Among the recommendations are choice of where and how women give birth.

Pain relief

They said pain relief should be offered where available and women should not be left alone during labour.

It also urged NHS chiefs to make the experience more pleasant by encouraging women to immerse themselves in water during the early stages of labour and to be able to play music of their choice.

NICE also wants to see a national surveillance project to allow proper comparisons on safety and cost effectiveness of different settings.

NICE deputy chief executive Andrea Sutcliffe said: "The evidence we have tells us that giving birth has never been safer than it is today.

The problem in all too many areas is that women have little option but to give birth in hospital
Mary Newburn, of the National Childbirth Trust

"Overall, less than one baby per 1,000 will die during or shortly after birth. Our primary concern is to make birth as normal as possible."

The recommendation comes after the government made a manifesto commitment to give women choice of where they give birth and what pain relief they use by 2009.

But the Royal College of Midwives has said care was being undermined by a shortage of midwives.

The college said another 10,000 are needed on top of the 40,000 currently working in the NHS.


Louise Silverton, from the college, also 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."

The National Childbirth Trust said financial pressures in the health service - it is facing a deficit of over 500m - had meant many NHS trusts had closed midwife-led birth centres.

Just 3% of women give birth at home despite over one in 10 saying they would like to.

Mary Newburn, the National Childbirth Trust's head of policy research, said: "The problem in all too many areas is that women have little option but to give birth in hospital.

"We welcome the recommendations, but it needs to be matched by action on the ground."

A Department of Health spokeswoman said the government has "turned a corner" over midwife staff numbers and was well on its way to meeting the 2009 target.

But she added: "The way that vision will be delivered will be decided locally."

Birthing centres to remain closed
15 Oct 05 |  Hampshire
Pregnant midwives shut baby units
21 Jun 05 |  Hampshire
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23 Jun 06 |  Have Your Say

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