10/11/2007 **Sunday Tribune*** Midwife Gezephi Gumede,73, hold a new born baby Matthews Timana which she delivered at Inanda, KZN. Gezephi has turned her four-room mud hut into a labour ward. Although she has no medical equipment but she is helping pregnant women in delivering their babies. She inherited this gift from her late who used to travel in different provinces to help pregnant women. "I have happed thousands of people to deliver ', said Gumede. Picture: SANDILE NDLOVU

London - Home births are the cheapest option for the NHS when the mother already has children, a study claims.

Second-time mothers who have a planned birth outside hospital need fewer interventions, such as forceps delivery, and it is just as safe for the baby.

The study found it would also be cheaper for first-time mothers to give birth at home but there was a greater risk that complications could have adverse effects on the baby.

Experts hope the findings may encourage more women to have their second and subsequent babies at home, and encourage more doctors to embrace the idea. given the potential savings to the NHS. The Birthplace in England study compared data for 65,000 women deemed at low risk of complications who planned to give birth in a hospital maternity department, at home or in a midwife-led birthing unit.

A new analysis in the British Medical Journal looked at the cost of giving birth in different places for first-time mothers, and those having a second or subsequent child.

Researchers at Oxford University, Warwick University and University College London found women at low risk of complications who gave birth either at home or a midwifery unit saved the NHS money.

A planned birth in an obstetric unit for mothers who already had children cost the most, at £1,142 per woman on average, while a planned home birth was cheapest at £780 per woman.

For women who have not had children before, a planned birth in a midwifery unit would save money compared with an obstetric unit, says the study.

A planned birth at home for first-time mothers was also cost-saving, but was “associated with poorer outcomes for the baby”.

Previous analysis of the same data found that first-time mothers were 2.8 times more likely to suffer serious problems giving birth at home than in hospital obstetric units. These included the death of the child and injuries to its upper arms or shoulders.

Around half of women who chose to give birth to their first baby at home had to be transferred to a hospital because of complications during labour.

In addition, one third of first-time mothers who entered a free-standing midwifery unit had to be transferred to obstetric units.

In England in 2010, 2.5 percent of mothers had a home birth – a slight fall on the previous year – with nine out of ten births occurring in hospital.

Health economist Liz Schroder, a co-author of the study, said: “At the time of the study, only half of the NHS trusts in England provided women with access to a midwifery unit, and occupancy levels were often low.

“The findings of the birthplace study may encourage women, particularly those having a second or subsequent baby, to request an ‘out of hospital’ birth.

“The potential for cost savings could make offering women more choice an attractive option for the NHS.”

The Royal College of Midwives said the research paved the way for changes to maternity services in the UK.

Deputy general secretary Louise Silverton said: “This and other research points out the substantial benefits of midwife-led care. It is better for mothers and babies, it is better for midwives and it is better for the NHS.

“The government constantly tells us it wants more for less, and this is a shining example of how that can be delivered.” -