Creating a dedicated home birth team in Tower Hamlets: a review of outcomes from the first year

Abstract

Background A dedicated home birth team was established at a large teaching hospital in a deprived inner London borough. Aim To increase the home birth rate in Tower Hamlets and offer continuity of carer to women opting for home birth. Methods Data were collected on all 90 women receiving care by the team. Data, including demographics, care episodes and maternal and neonatal outcomes, were recorded and analysed using Microsoft Excel 2010. Findings With a dedicated home birth team, the home birth rate in Tower Hamlets increased by 68% compared to the previous year, while still remaining a small proportion of all births in the borough. The overall transfer rate was 32.6%, in line with national figures. Outcomes for both mothers and babies were very good, with 89% of women who started their labour at home achieving a normal vaginal birth. Feedback was exceptionally positive, with 100% of women who provided feedback recommending the service. The women being referred and choosing homebirth were not demographically representative of the population of the borough. Conclusions The provision of a dedicated homebirth team in Tower Hamlets has been a positive addition to the area's existing maternity services. More needs to be done to improve the visibility of the team in order to secure more referrals and increase the homebirth rate, especially among the Bengali and other ethnic minority populations, to enable equitable access to homebirth.