Inclusion matters: Equality information report 2017.London: Barts Health NHS Trust; 2017

Brocklehurst P, Hardy P 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. 2011; 343

Downe S, Finlayson K. Interventions in Normal Labour and Birth Survey Report.London: RCM; 2016

Hollowell J, Chishlom A, Li Y, Malouf R. Evidence to support the National Maternity Review 2015: Report 4: A systematic review and narrative synthesis of the quantitative and qualitative literature on women's birth place preferences and experiences of choosing their intended place of birth in the UK.Oxford: National Perinatal Epidemiology Unit; 2015

Kramer MS., Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database Syst Rev. 2012; (8)

McAndrew F, Thompson J, Fellows L, Large A, Speed M, Renfrew MJ. Infant Feeding Survey 2010.London: NHS Digital; 2012

National Audit Office. Department of Health: Maternity Services in England. 2013. (accessed 1 July 2019)

Better Births: Improving Outcomes of Maternity Services in England.London: NHS England; 2016

Office for National Statistics. Birth characteristics in England and Wales: 2017. 2019. (accessed 21 June 2019)

Public Health England. Statistical release: breastfeeding at 6 to 8 weeks, Quarter 1 April to June 2018 (October 2018 release). 2018. (accessed 21 June 2019)

Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwifeled continuity models versus other models of care for childbearing women. Cochrane Database Syst Rev. 2016; 4

Scarf VL, Rossiter C, Vedam S Maternal and perinatal outcomes by planned place of birth among women with low-risk pregnancies in high-income countries: A systematic review and meta-analysis. Midwifery. 2018; 62:240-255

Smith LA, Price N, Simonite V, Burns EE. Incidence of and risk factors for perineal trauma: a prospective observational study. BMC Pregnancy Childbirth. 2013; 13

Sudworth FC, Hindley J, Cheatham C, Clarke P, McAree T. Creating a dedicated homebirth service: Results of a 3-year pilot. Br J Midwifery. 2018; 26:(3)164-170

Tower Hamlets Council. Borough Profile. 2018. (accessed 21 June 2019)

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

02 August 2019
Volume 27 · Issue 8



A dedicated home birth team was established at a large teaching hospital in a deprived inner London borough.


To increase the home birth rate in Tower Hamlets and offer continuity of carer to women opting for home birth.


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.


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.


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.

The majority (approximately 87%) of births in the UK take place in a hospital-based obstetric unit (National Audit Office, 2013) with the remainder in midwifery-led settings such as birth centres or the home. While giving birth at home has been shown to be a safe, cost-effective and well received option for women at low risk of complications (Birthplace in England Collaborative Group et al, 2011). In 2017, just 2.1% of babies were born at home in England and Wales (Office for National Statistics, 2019).

Tower Hamlets is home to one of the few freestanding midwifery units in the city, and therefore is one of only three London boroughs that offers pregnant women without complexities the choice of four locations in which to give birth. Despite home birth being an option, without a dedicated team, the home birth rate in 2017 was less than 0.4% in Tower Hamlets, with only 22 women having planned births at home.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month