A home birth carries a higher risk for the babies of first-time mothers, according to a landmark¹ study published in the British Medical Journal.

英国医学期刊的一项里程碑式研究显示，准母亲头胎在家生产对婴儿有较高的风险。

However, the chance of harm to the baby is still under 1%, the study of almost 65,000 births in England found.

For a second birth there was no difference in the risk to babies between home, a midwife-led unit or a doctor-led hospital unit.

Midwife-led care was in general much more likely to lead to a natural birth.

The Birthplace study is the largest carried out into the safety of different maternity²（母性） settings - comparing births at home, in midwife-led units attached to hospitals, those that are stand-alone and doctor-led hospital units.

All the women followed had healthy pregnancies³ and began labour with no known risk factors.

It found that, overall, birth is very safe wherever it happens.

The rates of complications, including stillbirth（死产） or other problems affecting the baby, was 5.3 per 1,000 births in hospital compared with 9.3 per 1,000 home births.

Prof Peter Brocklehurst, who led the research, said there were clear differences between women having their first baby and those having subsequent children.

He said: "The risk of an adverse⁴（不利的） outcome for a baby are higher for a woman planning her first baby at home than in all of the other settings, but there was no difference between the midwife and hospital obstetric（产科的） units."

About 45% of women planning to have their first baby at home were transferred during labour, although this was mainly because of delays in giving birth and the need for an epidural（硬膜上的） pain-relief injection, rather than because the baby was in distress⁵.

The transfer itself was not thought to be responsible for the difference because there was no raised risk for women moved from stand-alone midwife units to hospital during labour.

There was no difference in risk when women were having their second baby, whether that was at home, in a midwife unit or a traditional hospital setting.

The rate of transfer from home to hospital was much lower too, at just 12%.

Currently, about 90% of babies are born in medically-led hospital obstetric units. And in many areas women have a limited choice of where to have their baby.