Maternal Choice in the UK Should Be Promoted Despite the Current Era of Financial Austerity

The case for promoting maternal choice with regards to location of delivery is clear. The current default position is to give birth in hospital in a consultant-led unit. Yet, despite the ability to choose location, only 5% of women give birth in a midwife-led unit, and 3% at home. For most low risk mothers, perinatal outcomes are generally the same regardless of location, with the exception of first-time mothers who experience a small but significantly increased risk of complications from a home birth. Many women do not realise that there are safe alternatives to hospital-led delivery, yet non-obstetric units are associated with lower odds of unwanted interventions, and a higher likelihood of achieving a ‘normal birth’ and establishing breast feeding. The economic argument for promoting maternal choice is undeniable. Delivery in a midwife-led unit saves £130 compared to a hospital consultantled unit, whilst delivery at home saves £310. Increasing the uptake of delivery outside hospitals would potentially save millions of pounds. This dovetails with a wider long-term strategy to increase value in the NHS by moving care out of hospitals and into the community, streamlining high quality hospital resources for those who really need them.