The letter can help you to get your home birth by expressing your concerns and disappointment regarding the suspension of home births at the Trust, and presenting evidence-based information to support your desire to give birth at home with the support of a midwife. The letter highlights the benefits of home births, such as a lower rate of caesarean operations and other interventions, better outcomes for both mothers and babies, and lower costs. It also questions the Trust’s claims to inform women of their options and urges the Trust to reconsider the suspension of home births. By presenting a well-reasoned and evidence-based argument, the letter may convince the consultant midwife or consultant to reconsider the decision to suspend home births and to provide the option for women to give birth at home with the support of a midwife.
Consultant midwife / Consultant/Trust Directors Name
Dear [Consultant Midwife/ consultant ]
I am writing to express my deep concern and disappointment over the suspension of home births at your Trust. As a fit and healthy woman with a low-risk pregnancy, I strongly believe that I should have the option to give birth at home with the support of a midwife. I understand that your Trust provides maternity services based on good quality research, but it appears that your Trust is failing to do so in this case.
According to the World Health Organization (WHO), there is no health improvement when caesarean operations exceed 10-15%. Yet, your hospital currently has a caesarean operation rate more than double that. On the other hand, a study of over 64,000 births of fit and healthy first-time mothers found that women were more likely to have a normal birth at home, with home birth outcomes outperforming those of obstetric units, freestanding midwifery units, and alongside midwifery units.
While there is a small increased chance of an unexplained stillbirth at home compared to an obstetric unit, there is a far greater chance of avoiding a caesarean operation and other interventions if I were to stay at home with a midwife. In fact, statistics show that the caesarean surgery rate for healthy women is significantly lower for home births, freestanding midwifery units, and alongside midwifery units, compared to obstetric units.
Moreover, continuity of midwifery care has been shown to lead to better outcomes for both mothers and babies. Studies have found that women who receive continuity of midwifery care are less likely to lose their baby, less likely to have an episiotomy, and fewer have epidurals, instrumental deliveries, and pre-term births.
I am also concerned that your Trust may not be fully informing women of their options, despite your claims to do so. I strongly suggest that your staff obtain a copy of “Am I Allowed?” to ensure that they fully understand the risks and benefits of the services they are offering.
Finally, I would like to highlight that home births, continuity of midwifery care provided in the community, and in freestanding midwifery units, have been shown to be cheaper than centralised over-medicalised obstetric services. It is hard to understand why your Trust is failing to provide this, particularly during a Covid epidemic when protecting fit and healthy women from the risk of entering the very place where Covid has been shown to increase the risk of infection.
I urge you to reconsider the suspension of home births and provide women with the option to give birth in the place of their choice, with the support of a midwife. I would appreciate receiving your justification for this failure.
Brocklehurst P, Hardy P, Hollowell J et al (2011). Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: The Birthplace in England national prospective cohort study’ BMJ, Vol.343 (No.7840). d7400. ISSN 0959-535X.
Sandall J, Soltani H, Gates S et al (2016). Midwife-led continuity models of care versus other models of care for women during pregnancy, birth and early parenting, Cochrane Pregnancy and Childbirth Group, The Cochrane Library, 28 April. doi: 10.1002/14651858.CD004667.pub5.
WHO (2015). WHO Statement on caesarean section rates, World Health Organization, WHO/RHR/15.02.