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RCOG statement on BMJ paper looking at cost-effectiveness of alternative planned places of birth in low risk women

News 20 April 2012

This study looks at the cost-effectiveness of alternative planned places of birth using evidence from the Birthplace in England national prospective cohort study published in 2011.

The average costs cited in the paper were £1066, £1435, £1461, and £1631 for births planned at home, in freestanding midwifery units, in alongside midwifery units, and in obstetric units, respectively.

The authors concluded that for multiparous women at low risk of complications, planned birth at home was the most cost effective option.

For nulliparous low risk women, planned birth at home is still likely to be the most cost effective option but is associated with an increase in adverse perinatal outcomes.

Dr Tony Falconer, President of the Royal College of Obstetricians & Gynaecologists (RCOG) said:

“The results of this paper chime with the recommendations in our High Quality Women’s Health Care report which emphasised the need for a reorganisation of women’s health services. Currently, too much care is provided within secondary and tertiary settings. The RCOG supports women and midwives in making appropriate choices for place of birth based on the best evidence available.

“Transfer rates are an important consideration as the Birthplace study highlighted a large number of first time mothers planning delivery at home or in a freestanding unit required transfer to hospital during childbirth. This paper shows that the costs between freestanding and alongside midwifery units are very similar. The close proximity of alongside units provides easier transfer, should complications arise during the labour, thereby reducing stress and anxiety a woman may face. This is further evidence to support the development of alongside midwifery units.

“This paper shows that home birth is the most cost-effective place for delivery but decisions have to be based on safety and birth outcomes. For low-risk mothers expecting their second or third baby, home birth is a safe option.”

The full paper can be found here.