We remain hopeful that these guideline will assist in maternity service reform in Ireland where choice for women is extremely limited, sporadic and very much based upon geographic location.
Best wishes
Margaret Murphy
Lecturer
School of Nursing and Midwifery
University College Cork
[log in to unmask]
http://research.ucc.ie/profiles/C014/mgtmurphy
> On 5 Dec 2014, at 03:22, "Susan Crowther" <[log in to unmask]> wrote:
>
> Thank you informative.
> Of course the next challenge is translational work - policy into reality.
> With several generations convinced of hospital safety for all births - this will be a process.
> Yet what a wonderful breakthrough.
> Susan
>
> Dr Susan Crowther
> “Those finding themselves at birth need to pause and allow the profundity of its meaning to surface and inspire their actions”
> Senior Lecturer midwifery | AUT University, Dept of Midwifery|AUT North Campus|Rm AE116E
> School of Health Care Practice | Faculty of Health and Environmental Sciences
> Private Bag 92006, Auckland 1020, NZ, Tel: 09 921 9999 - ext. 7558 Mobile: 021 229 4858
> Blog: http://drsusancrowther.wordpress.com
> Twitter: http://twitter.com/SusanCrowtherMW
> www.aut.ac.nz | www.authealth.ac.nz
>
>
>
>
> -----Original Message-----
> From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of MIDWIFERY-RESEARCH automatic digest system
> Sent: Friday, 5 December 2014 1:03 p.m.
> To: [log in to unmask]
> Subject: MIDWIFERY-RESEARCH Digest - 3 Dec 2014 to 4 Dec 2014 (#2014-17)
>
> There are 7 messages totaling 2975 lines in this issue.
>
> Topics of the day:
>
> 1. NYTimes Report on NICE (5)
> 2. NYTimes Report on NICE
> 3. Lecturer in Midwifery opportunity at City University London
>
> ----------------------------------------------------------------------
>
> Date: Thu, 4 Dec 2014 07:34:07 -0500
> From: Midwyfejkb <[log in to unmask]>
> Subject: NYTimes Report on NICE
>
>
>
>
> I thought you might like to read the NYTimes version of the study results.
>
>
> Janet Brooks, Midwife
> Peekskill, NY
>
>
>
>
> British Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies
>
> By KATRIN BENNHOLD and CATHERINE SAINT LOUISDEC. 3, 2014
>
>
>
>
> Continue reading the main story
>
>
> Continue reading the main story
> Share This Page
>
> Share
>
> Tweet
>
> Email
>
> Save
>
> More
>
>
> Continue reading the main story
>
> LONDON — Reversing a generation of guidance on childbirth, Britain’s national health service on Wednesday advised healthy women that it was safer to have their babies at home, or in a birth center, than in a hospital.
> Women with uncomplicated pregnancies — about 45 percent of the total — were better off in the hands of midwives than hospital doctors during birth, according to new guidelines by the National Institute for Health and Care Excellence. For these low-risk mothers-to-be, giving birth in a traditional maternity ward increased the chances of surgical intervention and therefore infection, the regulator said.
> Hospital births were more likely to end in cesarean sections or involve episiotomies, a government financed 2011 study carried out by researchers at Oxford University showed. Women were more likely to be given epidurals, which numb the pain of labor but also increase the risk of a protracted birth that required forceps and damaged the perineum.
> The risk of death or serious complications for babies was the same in all three settings, with one exception: In the case of first-time mothers, home birth slightly increased that risk. Nine in 1,000 cases would experience serious complications, compared with five in 1,000 for babies born in a hospital.
> The findings could affect how hundreds of thousands of British women think about one of the biggest questions facing them. Nine in 10 of the roughly 700,000 babies born every year in England and Wales were delivered in a hospital.
> As recently as 2007, the guidelines had advised women to be “cautious” about home birth in the absence of conclusive risk assessments.
> Mark Baker, clinical practice director for the health institute, said first-time mothers with low birth risks would now be advised that a midwife-led unit would be particularly suitable for them, while mothers who already have given birth would be told that a home birth would be equally safe for the baby and safer for the mother than a hospital. But women are still free to choose the option they are most comfortable with, Dr. Baker said. “This is all about women having a choice,” he said.
> Not everyone was at ease with the new guidelines. “Things can go wrong very easily and we do feel this advice could be dangerous,” Lucy Jolin of the Birth Trauma Association told the BBC.
> So far doctors have not expressed any outrage over the decision. “If we had done this 20 years ago there would have been a revolution,” Dr. Baker said. “The penny has dropped. We’ve won the argument.”
> With the exception of the Netherlands, where home births have long been popular and relatively widespread, few developed countries have significant numbers of women opting for nonhospital deliveries. In the United States, where a culture of litigation adds a layer of complication, only 1.36 percent of births took place outside a hospital in 2012. Two-thirds of those nonhospital births took place at home and 29 percent at free-standing birthing centers, according to the National Center for Health Statistics.
>
> Continue reading the main story
>
> Continue reading the main story
>
> “We believe that hospitals and birthing centers are the safest places for birth, safer than home,” said Dr. Jeffrey L. Ecker, the chairman of the committee on obstetrics practice for American College of Obstetricians and Gynecologists. Under Britain’s integrated health system, if there is a complication, “they have a process and protocol for appropriately and quickly getting you somewhere else,” said Dr. Ecker, who added that he did not believe the British-style guidelines would come to America anytime soon. If such a recommendation were made in the United States, doctors might worry about losing patients to midwives.
> That concern is absent in Britain’s taxpayer-funded system. “There are no financial incentives in the U.K. for doctors to deliver in a particular setting because there is no personal gain,” said Dr. Baker of the health institute. Childbirth is “effectively an N.H.S. monopoly,” he said, referring to the National Health Service, Britain’s public health system.
> Holly Powell Kennedy, the immediate past president of the American College of Nurse-Midwives, an organization in the United States, praised the guidelines, saying, “This is how the practice should be happening.” In a hospital, “you are less able to labor without interventions,” Dr. Kennedy said.
> Reducing the number of hospital births would save the health service money, but British officials said budgets had not factored into the new guidelines. A traditional hospital birth costs the country’s health system about $2,500, with a home birth roughly $1,500 and a birth center about $2,200.
> “Yes, it’s a very expensive way to deliver healthy babies to healthy women,” Dr. Baker said about hospital births. “Saving money is not a crime.”
>
>
> Katrin Bennhold reported from London, and Catherine Saint Louis from New York.
>
> A version of this article appears in print on December 4, 2014, on page A6 of the New York edition with the headline: British Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies. Order Reprints| Today's Paper|Subscribe
>
>
> NEXT IN
>
> ------------------------------
>
> Date: Thu, 4 Dec 2014 12:40:16 +0000
> From: "Page, Lesley" <[log in to unmask]>
> Subject: Re: NYTimes Report on NICE
>
> Really interesting-and of great interest is the highlighting of the difference that tax based health care vs private/insurance based health care makes to incentives for doctors and impact on midwifery.
>
>
> Thanks for sending it
>
>
> Lesley
>
>
> Professor Lesley Page CBE
> Visiting Professor in Midwifery
> mobile 07747708630
>
>
>
> www.lesleypage.net<http://www.lesleypage.net/>
>
> www.facebook.com/page4pres<http://www.facebook.com/page4pres>
>
> twitter: @lesleypagercm
>
>
>
>
> ________________________________
> From: A forum for discussion on midwifery and reproductive health research. <[log in to unmask]> on behalf of Midwyfejkb <[log in to unmask]>
> Sent: 04 December 2014 12:34
> To: [log in to unmask]
> Subject: NYTimes Report on NICE
>
> I thought you might like to read the NYTimes version of the study results.
>
> Janet Brooks, Midwife
> Peekskill, NY
>
>
> British Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies
> By KATRIN BENNHOLD<http://topics.nytimes.com/top/reference/timestopics/people/b/katrin_bennhold/index.html> and CATHERINE SAINT LOUIS<http://topics.nytimes.com/top/reference/timestopics/people/s/catherine_saint_louis/index.html>DEC. 3, 2014
> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>
> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>Share This Page
>
> * Share
> * Tweet
> * Email
> * Save
> * More
>
> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>
> LONDON — Reversing a generation of guidance on childbirth, Britain’s national health service on Wednesday advised healthy women that it was safer to have their babies at home, or in a birth center, than in a hospital.
> Women with uncomplicated pregnancies — about 45 percent of the total — were better off in the hands of midwives<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/midwives/index.html?inline=nyt-classifier> than hospital doctors during birth, according to new guidelines by the National Institute for Health and Care Excellence<http://www.nice.org.uk/>. For these low-risk mothers-to-be, giving birth in a traditional maternity ward increased the chances of surgical intervention and therefore infection, the regulator said.
> Hospital births were more likely to end in cesarean sections or involve episiotomies, a government financed 2011 study carried out by researchers at Oxford University showed. Women were more likely to be given epidurals, which numb the pain of labor but also increase the risk of a protracted birth that required forceps and damaged the perineum.
> The risk of death or serious complications for babies was the same in all three settings, with one exception: In the case of first-time mothers, home birth slightly increased that risk. Nine in 1,000 cases would experience serious complications, compared with five in 1,000 for babies born in a hospital.
> The findings could affect how hundreds of thousands of British women think about one of the biggest questions facing them. Nine in 10 of the roughly 700,000 babies born every year in England and Wales were delivered in a hospital.
> As recently as 2007, the guidelines had advised women to be “cautious” about home birth in the absence of conclusive risk assessments.
> Mark Baker, clinical practice director for the health institute, said first-time mothers with low birth risks would now be advised that a midwife<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/midwives/index.html?inline=nyt-classifier>-led unit would be particularly suitable for them, while mothers who already have given birth would be told that a home birth would be equally safe for the baby and safer for the mother than a hospital. But women are still free to choose the option they are most comfortable with, Dr. Baker said. “This is all about women having a choice,” he said.
> Not everyone was at ease with the new guidelines. “Things can go wrong very easily and we do feel this advice could be dangerous,” Lucy Jolin of the Birth Trauma Association<http://www.birthtraumaassociation.org.uk/> told the BBC.
> So far doctors have not expressed any outrage over the decision. “If we had done this 20 years ago there would have been a revolution,” Dr. Baker said. “The penny has dropped. We’ve won the argument.”
> With the exception of the Netherlands, where home births have long been popular and relatively widespread, few developed countries have significant numbers of women opting for nonhospital deliveries. In the United States, where a culture of litigation adds a layer of complication, only 1.36 percent of births took place outside a hospital in 2012. Two-thirds of those nonhospital births took place at home and 29 percent at free-standing birthing centers, according to the National Center for Health Statistics.
> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-4>
> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-4>
> “We believe that hospitals and birthing centers are the safest places for birth, safer than home,” said Dr. Jeffrey L. Ecker, the chairman of the committee on obstetrics practice for American College of Obstetricians and Gynecologists. Under Britain’s integrated health system, if there is a complication, “they have a process and protocol for appropriately and quickly getting you somewhere else,” said Dr. Ecker, who added that he did not believe the British-style guidelines would come to America anytime soon. If such a recommendation were made in the United States, doctors might worry about losing patients to midwives.
> That concern is absent in Britain’s taxpayer-funded system. “There are no financial incentives in the U.K. for doctors to deliver in a particular setting because there is no personal gain,” said Dr. Baker of the health institute. Childbirth is “effectively an N.H.S. monopoly,” he said, referring to the National Health Service, Britain’s public health system.
> Holly Powell Kennedy, the immediate past president of the American College of Nurse-Midwives, an organization in the United States, praised the guidelines, saying, “This is how the practice should be happening.” In a hospital, “you are less able to labor without interventions,” Dr. Kennedy said.
> Reducing the number of hospital births would save the health service money, but British officials said budgets had not factored into the new guidelines. A traditional hospital birth costs the country’s health system about $2,500, with a home birth roughly $1,500 and a birth center about $2,200.
> “Yes, it’s a very expensive way to deliver healthy babies to healthy women,” Dr. Baker said about hospital births. “Saving money is not a crime.”
> Katrin Bennhold reported from London, and Catherine Saint Louis from New York.
> A version of this article appears in print on December 4, 2014, on page A6 of the New York edition with the headline: British Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies. Order Reprints<https://s100.copyright.com/AppDispatchServlet?contentID=http%3A%2F%2Fwww.nytimes.com%2F2014%2F12%2F04%2Fworld%2Fbritish-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html&publisherName=The+New+York+Times&publication=nytimes.com&token=&orderBeanReset=true&postType=&wordCount=767&title=British+Regulator+Urges+Home+Births+Over+Hospitals+for+Uncomplicated+Pregnancies&publicationDate=December+3%2C+2014&author=By%20Katrin%20Bennhold%20and%20Catherine%20Saint%20Louis>| Today's Paper<http://www.nytimes.com/pages/todayspaper/index.html>|Subscribe<http://www.nytimes.com/subscriptions/Multiproduct/lp839RF.html?campaignId=48JQY>
> NEXT IN EUROPE
>
> <http://www.nytimes.com/2014/12/04/world/europe/germany-carbon-emissions-environment.html>
>
> ------------------------------
>
> Date: Thu, 4 Dec 2014 13:13:08 +0000
> From: Soo Downe <[log in to unmask]>
> Subject: Re: NYTimes Report on NICE
>
> Yes – I’m amazed that they are so upfront about it!
>
> All the best
>
> soo
>
> From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Page, Lesley
> Sent: 04 December 2014 12:40
> To: [log in to unmask]
> Subject: Re: NYTimes Report on NICE
>
>
> Really interesting-and of great interest is the highlighting of the difference that tax based health care vs private/insurance based health care makes to incentives for doctors and impact on midwifery.
>
>
>
> Thanks for sending it
>
>
>
> Lesley
>
>
> Professor Lesley Page CBE
> Visiting Professor in Midwifery
> mobile 07747708630
>
>
>
> www.lesleypage.net<http://www.lesleypage.net/>
>
> www.facebook.com/page4pres<http://www.facebook.com/page4pres>
>
> twitter: @lesleypagercm
>
>
>
>
> ________________________________
> From: A forum for discussion on midwifery and reproductive health research. <[log in to unmask]<mailto:[log in to unmask]>> on behalf of Midwyfejkb <[log in to unmask]<mailto:[log in to unmask]>>
> Sent: 04 December 2014 12:34
> To: [log in to unmask]<mailto:[log in to unmask]>
> Subject: NYTimes Report on NICE
>
> I thought you might like to read the NYTimes version of the study results.
>
> Janet Brooks, Midwife
> Peekskill, NY
>
>
>
>
> British Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies
> By KATRIN BENNHOLD<http://topics.nytimes.com/top/reference/timestopics/people/b/katrin_bennhold/index.html> and CATHERINE SAINT LOUIS<http://topics.nytimes.com/top/reference/timestopics/people/s/catherine_saint_louis/index.html>DEC. 3, 2014
> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>
> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>Share This Page
> · Share
> · Tweet
> · Email
> · Save
> · More
> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>
> LONDON — Reversing a generation of guidance on childbirth, Britain’s national health service on Wednesday advised healthy women that it was safer to have their babies at home, or in a birth center, than in a hospital.
> Women with uncomplicated pregnancies — about 45 percent of the total — were better off in the hands of midwives<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/midwives/index.html?inline=nyt-classifier> than hospital doctors during birth, according to new guidelines by the National Institute for Health and Care Excellence<http://www.nice.org.uk/>. For these low-risk mothers-to-be, giving birth in a traditional maternity ward increased the chances of surgical intervention and therefore infection, the regulator said.
> Hospital births were more likely to end in cesarean sections or involve episiotomies, a government financed 2011 study carried out by researchers at Oxford University showed. Women were more likely to be given epidurals, which numb the pain of labor but also increase the risk of a protracted birth that required forceps and damaged the perineum.
> The risk of death or serious complications for babies was the same in all three settings, with one exception: In the case of first-time mothers, home birth slightly increased that risk. Nine in 1,000 cases would experience serious complications, compared with five in 1,000 for babies born in a hospital.
> The findings could affect how hundreds of thousands of British women think about one of the biggest questions facing them. Nine in 10 of the roughly 700,000 babies born every year in England and Wales were delivered in a hospital.
> As recently as 2007, the guidelines had advised women to be “cautious” about home birth in the absence of conclusive risk assessments.
> Mark Baker, clinical practice director for the health institute, said first-time mothers with low birth risks would now be advised that a midwife<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/midwives/index.html?inline=nyt-classifier>-led unit would be particularly suitable for them, while mothers who already have given birth would be told that a home birth would be equally safe for the baby and safer for the mother than a hospital. But women are still free to choose the option they are most comfortable with, Dr. Baker said. “This is all about women having a choice,” he said.
> Not everyone was at ease with the new guidelines. “Things can go wrong very easily and we do feel this advice could be dangerous,” Lucy Jolin of the Birth Trauma Association<http://www.birthtraumaassociation.org.uk/> told the BBC.
> So far doctors have not expressed any outrage over the decision. “If we had done this 20 years ago there would have been a revolution,” Dr. Baker said. “The penny has dropped. We’ve won the argument.”
> With the exception of the Netherlands, where home births have long been popular and relatively widespread, few developed countries have significant numbers of women opting for nonhospital deliveries. In the United States, where a culture of litigation adds a layer of complication, only 1.36 percent of births took place outside a hospital in 2012. Two-thirds of those nonhospital births took place at home and 29 percent at free-standing birthing centers, according to the National Center for Health Statistics.
> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-4>
> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-4>
> “We believe that hospitals and birthing centers are the safest places for birth, safer than home,” said Dr. Jeffrey L. Ecker, the chairman of the committee on obstetrics practice for American College of Obstetricians and Gynecologists. Under Britain’s integrated health system, if there is a complication, “they have a process and protocol for appropriately and quickly getting you somewhere else,” said Dr. Ecker, who added that he did not believe the British-style guidelines would come to America anytime soon. If such a recommendation were made in the United States, doctors might worry about losing patients to midwives.
> That concern is absent in Britain’s taxpayer-funded system. “There are no financial incentives in the U.K. for doctors to deliver in a particular setting because there is no personal gain,” said Dr. Baker of the health institute. Childbirth is “effectively an N.H.S. monopoly,” he said, referring to the National Health Service, Britain’s public health system.
> Holly Powell Kennedy, the immediate past president of the American College of Nurse-Midwives, an organization in the United States, praised the guidelines, saying, “This is how the practice should be happening.” In a hospital, “you are less able to labor without interventions,” Dr. Kennedy said.
> Reducing the number of hospital births would save the health service money, but British officials said budgets had not factored into the new guidelines. A traditional hospital birth costs the country’s health system about $2,500, with a home birth roughly $1,500 and a birth center about $2,200.
> “Yes, it’s a very expensive way to deliver healthy babies to healthy women,” Dr. Baker said about hospital births. “Saving money is not a crime.”
> Katrin Bennhold reported from London, and Catherine Saint Louis from New York.
> A version of this article appears in print on December 4, 2014, on page A6 of the New York edition with the headline: British Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies. Order Reprints<https://s100.copyright.com/AppDispatchServlet?contentID=http%3A%2F%2Fwww.nytimes.com%2F2014%2F12%2F04%2Fworld%2Fbritish-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html&publisherName=The+New+York+Times&publication=nytimes.com&token=&orderBeanReset=true&postType=&wordCount=767&title=British+Regulator+Urges+Home+Births+Over+Hospitals+for+Uncomplicated+Pregnancies&publicationDate=December+3%2C+2014&author=By%20Katrin%20Bennhold%20and%20Catherine%20Saint%20Louis>| Today's Paper<http://www.nytimes.com/pages/todayspaper/index.html>|Subscribe<http://www.nytimes.com/subscriptions/Multiproduct/lp839RF.html?campaignId=48JQY>
> NEXT IN EUROPE
>
> ------------------------------
>
> Date: Thu, 4 Dec 2014 08:35:29 -0500
> From: Patricia Burkhardt <[log in to unmask]>
> Subject: Re: NYTimes Report on NICE
>
> Thanks, Janet. Really like the comments of Lesley Paige and Soo Downe.
> Will I see you on Monday at the NYSALM Annual Meeting? Pat
>
> On Thu, Dec 4, 2014 at 7:34 AM, Midwyfejkb <
> [log in to unmask]> wrote:
>
>> I thought you might like to read the NYTimes version of the study
>> results.
>>
>> Janet Brooks, Midwife
>> Peekskill, NY
>>
>>
>> British Regulator Urges Home Births Over Hospitals for Uncomplicated
>> Pregnancies
>> By KATRIN BENNHOLD
>> <http://topics.nytimes.com/top/reference/timestopics/people/b/katrin_bennhold/index.html>
>> and CATHERINE SAINT LOUIS
>> <http://topics.nytimes.com/top/reference/timestopics/people/s/catherine_saint_louis/index.html>DEC.
>> 3, 2014
>> Continue reading the main story
>> <http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>
>> Continue reading the main story
>> <http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>Share
>> This Page
>>
>> - Share
>> - Tweet
>> - Email
>> - Save
>> - More
>>
>> Continue reading the main story
>> <http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>
>> LONDON — Reversing a generation of guidance on childbirth, Britain’s
>> national health service on Wednesday advised healthy women that it was
>> safer to have their babies at home, or in a birth center, than in a
>> hospital.
>> Women with uncomplicated pregnancies — about 45 percent of the total —
>> were better off in the hands of midwives
>> <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/midwives/index.html?inline=nyt-classifier> than
>> hospital doctors during birth, according to new guidelines by the National
>> Institute for Health and Care Excellence <http://www.nice.org.uk/>. For
>> these low-risk mothers-to-be, giving birth in a traditional maternity ward
>> increased the chances of surgical intervention and therefore infection, the
>> regulator said.
>> Hospital births were more likely to end in cesarean sections or involve
>> episiotomies, a government financed 2011 study carried out by researchers
>> at Oxford University showed. Women were more likely to be given epidurals,
>> which numb the pain of labor but also increase the risk of a protracted
>> birth that required forceps and damaged the perineum.
>> The risk of death or serious complications for babies was the same in all
>> three settings, with one exception: In the case of first-time mothers, home
>> birth slightly increased that risk. Nine in 1,000 cases would experience
>> serious complications, compared with five in 1,000 for babies born in a
>> hospital.
>> The findings could affect how hundreds of thousands of British women think
>> about one of the biggest questions facing them. Nine in 10 of the roughly
>> 700,000 babies born every year in England and Wales were delivered in a
>> hospital.
>> As recently as 2007, the guidelines had advised women to be “cautious”
>> about home birth in the absence of conclusive risk assessments.
>> Mark Baker, clinical practice director for the health institute, said
>> first-time mothers with low birth risks would now be advised that a
>> midwife
>> <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/midwives/index.html?inline=nyt-classifier>-led
>> unit would be particularly suitable for them, while mothers who already
>> have given birth would be told that a home birth would be equally safe for
>> the baby and safer for the mother than a hospital. But women are still free
>> to choose the option they are most comfortable with, Dr. Baker said. “This
>> is all about women having a choice,” he said.
>> Not everyone was at ease with the new guidelines. “Things can go wrong
>> very easily and we do feel this advice could be dangerous,” Lucy Jolin of
>> the Birth Trauma Association <http://www.birthtraumaassociation.org.uk/> told
>> the BBC.
>> So far doctors have not expressed any outrage over the decision. “If we
>> had done this 20 years ago there would have been a revolution,” Dr. Baker
>> said. “The penny has dropped. We’ve won the argument.”
>> With the exception of the Netherlands, where home births have long been
>> popular and relatively widespread, few developed countries have significant
>> numbers of women opting for nonhospital deliveries. In the United States,
>> where a culture of litigation adds a layer of complication, only 1.36
>> percent of births took place outside a hospital in 2012. Two-thirds of
>> those nonhospital births took place at home and 29 percent at free-standing
>> birthing centers, according to the National Center for Health Statistics.
>> Continue reading the main story
>> <http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-4>
>> Continue reading the main story
>> <http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-4>
>> “We believe that hospitals and birthing centers are the safest places for
>> birth, safer than home,” said Dr. Jeffrey L. Ecker, the chairman of the
>> committee on obstetrics practice for American College of Obstetricians and
>> Gynecologists. Under Britain’s integrated health system, if there is a
>> complication, “they have a process and protocol for appropriately and
>> quickly getting you somewhere else,” said Dr. Ecker, who added that he did
>> not believe the British-style guidelines would come to America anytime
>> soon. If such a recommendation were made in the United States, doctors
>> might worry about losing patients to midwives.
>> That concern is absent in Britain’s taxpayer-funded system. “There are no
>> financial incentives in the U.K. for doctors to deliver in a particular
>> setting because there is no personal gain,” said Dr. Baker of the health
>> institute. Childbirth is “effectively an N.H.S. monopoly,” he said,
>> referring to the National Health Service, Britain’s public health system.
>> Holly Powell Kennedy, the immediate past president of the American College
>> of Nurse-Midwives, an organization in the United States, praised the
>> guidelines, saying, “This is how the practice should be happening.” In a
>> hospital, “you are less able to labor without interventions,” Dr. Kennedy
>> said.
>> Reducing the number of hospital births would save the health service
>> money, but British officials said budgets had not factored into the new
>> guidelines. A traditional hospital birth costs the country’s health system
>> about $2,500, with a home birth roughly $1,500 and a birth center about
>> $2,200.
>> “Yes, it’s a very expensive way to deliver healthy babies to healthy
>> women,” Dr. Baker said about hospital births. “Saving money is not a crime.”
>> Katrin Bennhold reported from London, and Catherine Saint Louis from
>> New York.
>> A version of this article appears in print on December 4, 2014, on page
>> A6 of the New York edition with the headline: British Regulator Urges
>> Home Births Over Hospitals for Uncomplicated Pregnancies. Order Reprints
>> <https://s100.copyright.com/AppDispatchServlet?contentID=http%3A%2F%2Fwww.nytimes.com%2F2014%2F12%2F04%2Fworld%2Fbritish-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html&publisherName=The+New+York+Times&publication=nytimes.com&token=&orderBeanReset=true&postType=&wordCount=767&title=British+Regulator+Urges+Home+Births+Over+Hospitals+for+Uncomplicated+Pregnancies&publicationDate=December+3%2C+2014&author=By%20Katrin%20Bennhold%20and%20Catherine%20Saint%20Louis>
>> | Today's Paper <http://www.nytimes.com/pages/todayspaper/index.html>|
>> Subscribe
>> <http://www.nytimes.com/subscriptions/Multiproduct/lp839RF.html?campaignId=48JQY>
>> NEXT IN EUROPE
>>
>>
>> <http://www.nytimes.com/2014/12/04/world/europe/germany-carbon-emissions-environment.html>
>
>
>
> --
> Patricia Burkhardt, LM, CM, DrPH, FACNM
> President, New York State Association of Licensed Midwives (NYSALM)
> New York University
> Adjunct Clinical Associate Professor
> 718 644-8963 (Cell)
> 718 855-9241 (Home)
>
> ------------------------------
>
> Date: Thu, 4 Dec 2014 19:01:15 +0100
> From: Alexander Sophie <[log in to unmask]>
> Subject: Re: NYTimes Report on NICE
>
> Except that no one knows about con founders. It is like when I say CS rates are 14% in Iceland and 50% in Brazil. And look at the effect: maternal and perinatal mortality are much lower in Iceland.
>
> But in fact it is probably a complete package of higher level of human development. And in these high index countries, there is: less poverty, higher equity, midwife led births, higher rates on the PISA educational scores, a Beveridge ( as opposed to a Bismark) model for financing care.
>
> But I don't think one can single out just one element.
>
> Sophie Alexander
>
>> ?Really interesting-and of great interest is the highlighting of the difference that tax based health care vs private/insurance based health care makes to incentives for doctors and impact on midwifery.
>>
>>
>> Thanks for sending it
>>
>>
>> Lesley
>>
>>
>> Professor Lesley Page CBE
>> Visiting Professor in Midwifery
>> mobile 07747708630
>>
>>
>>
>> www.lesleypage.net<http://www.lesleypage.net/>
>>
>> www.facebook.com/page4pres<http://www.facebook.com/page4pres>
>>
>> twitter: @lesleypagercm
>>
>>
>>
>>
>> ________________________________
>> From: A forum for discussion on midwifery and reproductive health research. <[log in to unmask]> on behalf of Midwyfejkb <[log in to unmask]>
>> Sent: 04 December 2014 12:34
>> To: [log in to unmask]
>> Subject: NYTimes Report on NICE
>>
>> I thought you might like to read the NYTimes version of the study results.
>>
>> Janet Brooks, Midwife
>> Peekskill, NY
>>
>>
>> British Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies
>> By KATRIN BENNHOLD<http://topics.nytimes.com/top/reference/timestopics/people/b/katrin_bennhold/index.html> and CATHERINE SAINT LOUIS<http://topics.nytimes.com/top/reference/timestopics/people/s/catherine_saint_louis/index.html>DEC. 3, 2014
>> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>
>> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>Share This Page
>>
>> * Share
>> * Tweet
>> * Email
>> * Save
>> * More
>>
>> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>
>> LONDON ? Reversing a generation of guidance on childbirth, Britain?s national health service on Wednesday advised healthy women that it was safer to have their babies at home, or in a birth center, than in a hospital.
>> Women with uncomplicated pregnancies ? about 45 percent of the total ? were better off in the hands of midwives<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/midwives/index.html?inline=nyt-classifier> than hospital doctors during birth, according to new guidelines by the National Institute for Health and Care Excellence<http://www.nice.org.uk/>. For these low-risk mothers-to-be, giving birth in a traditional maternity ward increased the chances of surgical intervention and therefore infection, the regulator said.
>> Hospital births were more likely to end in cesarean sections or involve episiotomies, a government financed 2011 study carried out by researchers at Oxford University showed. Women were more likely to be given epidurals, which numb the pain of labor but also increase the risk of a protracted birth that required forceps and damaged the perineum.
>> The risk of death or serious complications for babies was the same in all three settings, with one exception: In the case of first-time mothers, home birth slightly increased that risk. Nine in 1,000 cases would experience serious complications, compared with five in 1,000 for babies born in a hospital.
>> The findings could affect how hundreds of thousands of British women think about one of the biggest questions facing them. Nine in 10 of the roughly 700,000 babies born every year in England and Wales were delivered in a hospital.
>> As recently as 2007, the guidelines had advised women to be ?cautious? about home birth in the absence of conclusive risk assessments.
>> Mark Baker, clinical practice director for the health institute, said first-time mothers with low birth risks would now be advised that a midwife<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/midwives/index.html?inline=nyt-classifier>-led unit would be particularly suitable for them, while mothers who already have given birth would be told that a home birth would be equally safe for the baby and safer for the mother than a hospital. But women are still free to choose the option they are most comfortable with, Dr. Baker said. ?This is all about women having a choice,? he said.
>> Not everyone was at ease with the new guidelines. ?Things can go wrong very easily and we do feel this advice could be dangerous,? Lucy Jolin of the Birth Trauma Association<http://www.birthtraumaassociation.org.uk/> told the BBC.
>> So far doctors have not expressed any outrage over the decision. ?If we had done this 20 years ago there would have been a revolution,? Dr. Baker said. ?The penny has dropped. We?ve won the argument.?
>> With the exception of the Netherlands, where home births have long been popular and relatively widespread, few developed countries have significant numbers of women opting for nonhospital deliveries. In the United States, where a culture of litigation adds a layer of complication, only 1.36 percent of births took place outside a hospital in 2012. Two-thirds of those nonhospital births took place at home and 29 percent at free-standing birthing centers, according to the National Center for Health Statistics.
>> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-4>
>> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-4>
>> ?We believe that hospitals and birthing centers are the safest places for birth, safer than home,? said Dr. Jeffrey L. Ecker, the chairman of the committee on obstetrics practice for American College of Obstetricians and Gynecologists. Under Britain?s integrated health system, if there is a complication, ?they have a process and protocol for appropriately and quickly getting you somewhere else,? said Dr. Ecker, who added that he did not believe the British-style guidelines would come to America anytime soon. If such a recommendation were made in the United States, doctors might worry about losing patients to midwives.
>> That concern is absent in Britain?s taxpayer-funded system. ?There are no financial incentives in the U.K. for doctors to deliver in a particular setting because there is no personal gain,? said Dr. Baker of the health institute. Childbirth is ?effectively an N.H.S. monopoly,? he said, referring to the National Health Service, Britain?s public health system.
>> Holly Powell Kennedy, the immediate past president of the American College of Nurse-Midwives, an organization in the United States, praised the guidelines, saying, ?This is how the practice should be happening.? In a hospital, ?you are less able to labor without interventions,? Dr. Kennedy said.
>> Reducing the number of hospital births would save the health service money, but British officials said budgets had not factored into the new guidelines. A traditional hospital birth costs the country?s health system about $2,500, with a home birth roughly $1,500 and a birth center about $2,200.
>> ?Yes, it?s a very expensive way to deliver healthy babies to healthy women,? Dr. Baker said about hospital births. ?Saving money is not a crime.?
>> Katrin Bennhold reported from London, and Catherine Saint Louis from New York.
>> A version of this article appears in print on December 4, 2014, on page A6 of the New York edition with the headline: British Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies. Order Reprints<https://s100.copyright.com/AppDispatchServlet?contentID=http%3A%2F%2Fwww.nytimes.com%2F2014%2F12%2F04%2Fworld%2Fbritish-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html&publisherName=The+New+York+Times&publication=nytimes.com&token=&orderBeanReset=true&postType=&wordCount=767&title=British+Regulator+Urges+Home+Births+Over+Hospitals+for+Uncomplicated+Pregnancies&publicationDate=December+3%2C+2014&author=By%20Katrin%20Bennhold%20and%20Catherine%20Saint%20Louis>| Today's Paper<http://www.nytimes.com/pages/todayspaper/index.html>|Subscribe<http://www.nytimes.com/subscriptions/Multiproduct/lp839RF.html?campaignId=48JQY>
>> NEXT IN EUROPE
>>
>> <http://www.nytimes.com/2014/12/04/world/europe/germany-carbon-emissions-environment.html>
>
> ------------------------------
>
> Date: Thu, 4 Dec 2014 22:19:56 +0000
> From: "McCourt, Christine" <[log in to unmask]>
> Subject: Lecturer in Midwifery opportunity at City University London
>
> Dear list members
>
> City University is offering a lecturer/senior lecturer post. Full details can be found via the following link:
>
> http://www2.i-grasp.com/fe/tpl_cityuniversity01.asp?s=4A515F4E5A565B1A&jobid=95449,8747869823&key=102336790&c=54711454728715&pagestamp=segidwvfjsydfrvlow
>
> Please note that there there may be flexibility around the precise requirements of this post, so it is worth having an informal discussion if you are interested. Potential applicants can contact Judith Sunderland to find out more about the role, the Lead Midwife for Education: [log in to unmask]
>
> If you would like to know more about our research profile and interests, you are welcome to contact me, but please note I am out of the UK until next week.
> Please do feel free to circulate this information. The application deadline is in mid-January.
>
> Christine
>
> Christine McCourt
> PhD Programme Director &
> Professor of Maternal & Child Health
> Centre for Maternal and Child Health<http://www.city.ac.uk/health/research/centre-for-maternal-and-child-health-research/models-of-care>
> School of Health Sciences<http://www.city.ac.uk/health>
> City University London
> 1 Myddelton Street
> London EC1R 1UW
>
> Tel: 0207 040 5863
>
>
> Want to further your clinical and academic career? To find out more about City University London's MSc Advanced Practice Midwifery programme please click here<http://www.city.ac.uk/courses/postgraduate/advanced-practice-in-health-and-social-care-midwifery#course-detail=0>.
>
>
>
> ------------------------------
>
> Date: Thu, 4 Dec 2014 23:45:01 +0000
> From: "Macfarlane, Alison" <[log in to unmask]>
> Subject: Re: NYTimes Report on NICE
>
> True, but it's interesting that NYT comments on tax based health care offering the opportunities for moving from medically led to midwife-led care for women without risk factors. Pity that our government is actively trying to move to a US style model.
>
> Alison Macfarlane
>
> ________________________________________
> From: Alexander Sophie <[log in to unmask]>
> Sent: 04 December 2014 18:01
> To: [log in to unmask]
> Subject: Re: NYTimes Report on NICE
>
> Except that no one knows about con founders. It is like when I say CS rates are 14% in Iceland and 50% in Brazil. And look at the effect: maternal and perinatal mortality are much lower in Iceland.
>
> But in fact it is probably a complete package of higher level of human development. And in these high index countries, there is: less poverty, higher equity, midwife led births, higher rates on the PISA educational scores, a Beveridge ( as opposed to a Bismark) model for financing care.
>
> But I don't think one can single out just one element.
>
> Sophie Alexander
>
>> ?Really interesting-and of great interest is the highlighting of the difference that tax based health care vs private/insurance based health care makes to incentives for doctors and impact on midwifery.
>>
>>
>> Thanks for sending it
>>
>>
>> Lesley
>>
>>
>> Professor Lesley Page CBE
>> Visiting Professor in Midwifery
>> mobile 07747708630
>>
>>
>>
>> www.lesleypage.net<http://www.lesleypage.net/>
>>
>> www.facebook.com/page4pres<http://www.facebook.com/page4pres>
>>
>> twitter: @lesleypagercm
>>
>>
>>
>>
>> ________________________________
>> From: A forum for discussion on midwifery and reproductive health research. <[log in to unmask]> on behalf of Midwyfejkb <[log in to unmask]>
>> Sent: 04 December 2014 12:34
>> To: [log in to unmask]
>> Subject: NYTimes Report on NICE
>>
>> I thought you might like to read the NYTimes version of the study results.
>>
>> Janet Brooks, Midwife
>> Peekskill, NY
>>
>>
>> British Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies
>> By KATRIN BENNHOLD<http://topics.nytimes.com/top/reference/timestopics/people/b/katrin_bennhold/index.html> and CATHERINE SAINT LOUIS<http://topics.nytimes.com/top/reference/timestopics/people/s/catherine_saint_louis/index.html>DEC. 3, 2014
>> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>
>> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>Share This Page
>>
>> * Share
>> * Tweet
>> * Email
>> * Save
>> * More
>>
>> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-1>
>> LONDON ? Reversing a generation of guidance on childbirth, Britain?s national health service on Wednesday advised healthy women that it was safer to have their babies at home, or in a birth center, than in a hospital.
>> Women with uncomplicated pregnancies ? about 45 percent of the total ? were better off in the hands of midwives<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/midwives/index.html?inline=nyt-classifier> than hospital doctors during birth, according to new guidelines by the National Institute for Health and Care Excellence<http://www.nice.org.uk/>. For these low-risk mothers-to-be, giving birth in a traditional maternity ward increased the chances of surgical intervention and therefore infection, the regulator said.
>> Hospital births were more likely to end in cesarean sections or involve episiotomies, a government financed 2011 study carried out by researchers at Oxford University showed. Women were more likely to be given epidurals, which numb the pain of labor but also increase the risk of a protracted birth that required forceps and damaged the perineum.
>> The risk of death or serious complications for babies was the same in all three settings, with one exception: In the case of first-time mothers, home birth slightly increased that risk. Nine in 1,000 cases would experience serious complications, compared with five in 1,000 for babies born in a hospital.
>> The findings could affect how hundreds of thousands of British women think about one of the biggest questions facing them. Nine in 10 of the roughly 700,000 babies born every year in England and Wales were delivered in a hospital.
>> As recently as 2007, the guidelines had advised women to be ?cautious? about home birth in the absence of conclusive risk assessments.
>> Mark Baker, clinical practice director for the health institute, said first-time mothers with low birth risks would now be advised that a midwife<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/midwives/index.html?inline=nyt-classifier>-led unit would be particularly suitable for them, while mothers who already have given birth would be told that a home birth would be equally safe for the baby and safer for the mother than a hospital. But women are still free to choose the option they are most comfortable with, Dr. Baker said. ?This is all about women having a choice,? he said.
>> Not everyone was at ease with the new guidelines. ?Things can go wrong very easily and we do feel this advice could be dangerous,? Lucy Jolin of the Birth Trauma Association<http://www.birthtraumaassociation.org.uk/> told the BBC.
>> So far doctors have not expressed any outrage over the decision. ?If we had done this 20 years ago there would have been a revolution,? Dr. Baker said. ?The penny has dropped. We?ve won the argument.?
>> With the exception of the Netherlands, where home births have long been popular and relatively widespread, few developed countries have significant numbers of women opting for nonhospital deliveries. In the United States, where a culture of litigation adds a layer of complication, only 1.36 percent of births took place outside a hospital in 2012. Two-thirds of those nonhospital births took place at home and 29 percent at free-standing birthing centers, according to the National Center for Health Statistics.
>> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-4>
>> Continue reading the main story<http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?emc=edit_th_20141204&nl=todaysheadlines&nlid=34281212&_r=0#story-continues-4>
>> ?We believe that hospitals and birthing centers are the safest places for birth, safer than home,? said Dr. Jeffrey L. Ecker, the chairman of the committee on obstetrics practice for American College of Obstetricians and Gynecologists. Under Britain?s integrated health system, if there is a complication, ?they have a process and protocol for appropriately and quickly getting you somewhere else,? said Dr. Ecker, who added that he did not believe the British-style guidelines would come to America anytime soon. If such a recommendation were made in the United States, doctors might worry about losing patients to midwives.
>> That concern is absent in Britain?s taxpayer-funded system. ?There are no financial incentives in the U.K. for doctors to deliver in a particular setting because there is no personal gain,? said Dr. Baker of the health institute. Childbirth is ?effectively an N.H.S. monopoly,? he said, referring to the National Health Service, Britain?s public health system.
>> Holly Powell Kennedy, the immediate past president of the American College of Nurse-Midwives, an organization in the United States, praised the guidelines, saying, ?This is how the practice should be happening.? In a hospital, ?you are less able to labor without interventions,? Dr. Kennedy said.
>> Reducing the number of hospital births would save the health service money, but British officials said budgets had not factored into the new guidelines. A traditional hospital birth costs the country?s health system about $2,500, with a home birth roughly $1,500 and a birth center about $2,200.
>> ?Yes, it?s a very expensive way to deliver healthy babies to healthy women,? Dr. Baker said about hospital births. ?Saving money is not a crime.?
>> Katrin Bennhold reported from London, and Catherine Saint Louis from New York.
>> A version of this article appears in print on December 4, 2014, on page A6 of the New York edition with the headline: British Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies. Order Reprints<https://s100.copyright.com/AppDispatchServlet?contentID=http%3A%2F%2Fwww.nytimes.com%2F2014%2F12%2F04%2Fworld%2Fbritish-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html&publisherName=The+New+York+Times&publication=nytimes.com&token=&orderBeanReset=true&postType=&wordCount=767&title=British+Regulator+Urges+Home+Births+Over+Hospitals+for+Uncomplicated+Pregnancies&publicationDate=December+3%2C+2014&author=By%20Katrin%20Bennhold%20and%20Catherine%20Saint%20Louis>| Today's Paper<http://www.nytimes.com/pages/todayspaper/index.html>|Subscribe<http://www.nytimes.com/subscriptions/Multiproduct/lp839RF.html?campaignId=48JQY>
>> NEXT IN EUROPE
>>
>> <http://www.nytimes.com/2014/12/04/world/europe/germany-carbon-emissions-environment.html>
>
>
> ------------------------------
>
> End of MIDWIFERY-RESEARCH Digest - 3 Dec 2014 to 4 Dec 2014 (#2014-17)
> **********************************************************************
|
