First-time mothers who opt for a home birth are almost three times more likely to have a baby who dies or suffers brain damage, a major new report has shown.
Babies born to first-time mothers who choose a home birth are almost three times more likely to die or suffer a medical complication, according to a report.
The Birthplace in England study found these babies were 2.8 times more likely to suffer serious problems compared with those born in hospital obstetric units.
Problems include stillbirth after the start of labour, the baby dying within the first week of birth, brain injury, fractures to the upper arm or shoulder during birth, and faeces in the lung, which can require intense medical attention.
Conditions can vary in severity and their long-term impact but are linked to trauma at birth or the baby becoming distressed or being deprived of oxygen during labour.
There was no increased risk for babies whose birth was planned at units led by midwives, either ones that stand alone in the community or which are attached to a hospital. There was also no increased risk for second or subsequent babies whose mothers planned a home birth.
Serious adverse outcomes for the baby are rare - occurring just 3.5 times for every 1,000 babies whose birth was planned in an obstetric unit. But the research, carried out at Oxford University, shows this figure rises to 9.5 per 1,000 babies if the mother chooses a home birth.
The study compared data for almost 65,000 women at low risk of complications who planned to give birth in obstetric units, at home or at a midwife-led unit. The researchers stressed that giving birth is generally very safe. For the entire group of women studied, 250 babies suffered an adverse outcome at birth.
Professor Peter Brocklehurst, who led the study, published in the British Medical Journal, and who now works at University College London, said adverse events are very uncommon.
He added: "These results should reassure pregnant women planning their birth that they can make informed decisions about where they'd most like the birth to happen, knowing that giving birth in England is generally very safe."
Royal College of Midwives chief executive and general secretary Cathy Warwick said: "This study demonstrates clearly the safety of midwife-led care."