Birthplace in England Study (BMJ, 2011)
88% normal birth at home vs 58% in hospital. No safety difference.
64,538 low-risk women. Experienced mothers: no significant difference in adverse outcomes between home and hospital. Normal birth rate: 88% at home vs 58% in hospital. C-section: 0.6-5.1% at home vs 6.5-15.5% in hospital.
The Birthplace in England Study is the largest prospective study ever conducted of where to give birth. The research team enrolled 64,538 low-risk women in the UK and tracked outcomes across four planned birth settings: home, freestanding midwifery unit, alongside midwifery unit, and obstetric (hospital) unit.
The headline finding for experienced mothers, those who had given birth before, was that there was no significant difference in adverse perinatal outcomes between settings. The interventions told a different story. Women planning home birth had an 88 percent normal birth rate. Women planning hospital birth had 58 percent.
Cesarean rates ranged from 0.6 to 5.1 percent at home compared with 6.5 to 15.5 percent in hospital. The study was funded by the UK Department of Health and reviewed by independent statisticians.
64,538
Low-risk women in the study
88%
Normal birth rate at home
58%
Normal birth rate in hospital
~3x
C-section rate gap, hospital vs home
Why it matters
The largest study ever done found that for experienced low-risk mothers, where they choose to give birth changes the interventions they receive far more than the safety of the outcome.
This is one finding from the research library behind How to Birth a Mother. Everything here traces back to a study, a dataset, or a systematic review.