Every risk you MUST know before having a homebirth as mother, 34, and baby die amid tragic complications

More than nine in ten babies in the UK are born in hospital, but rates of home births are rising. 

Advocates say there are many advantages to delivery outside a medical setting: You’re in the comfort of your own home, there’s little to no medical intervention and, in most cases, the mother — not her physician, or hospital staff — is in control. 

But home births are controversial due to the lack of specialised care at hand if something goes seriously wrong. 

Experts have long argued that the evidence about the risks of home births and the relative safety of hospital-based births is too often ignored by home birth advocates.

Such risks have again been thrown into the spotlight amid a heartbreaking inquest into the death of a mother, 34, and her newborn baby who both died after she gave birth at home. 

Jennifer Cahill, from Prestwich, Greater Manchester, delivered her second child, baby Agnes Lily in the presence of her husband Rob and two midwives in June last year.

She decided on a home birth after feeling ‘unsupported’ in hospital while delivering her son three years earlier.

But Mrs Cahill, an international export manager, was at higher risk and both she and Agnes were soon rushed to hospital after suffering complications during the birth. 

She died a day later at North Manchester General Hospital, while Agnes survived for three days before passing away.

Around one in 50 women in England and Wales give birth at home, according to the NHS.

In the US, almost 50,000 births took place outside of hospital in 2023, according to an analysis published in the Journal of Perinatal Medicine.

According to Professor Dimitrios Siassakos, an honorary consultant in obstetrics at University College London Hospital, problems in labour arise far more commonly than many people think.  

He told the Daily Mail: ‘The best predictor of risk during childbirth is previous pregnancies.

‘Women with a previous uncomplicated vaginal birth have good chances of a straightforward birth without direct medical attention.

‘But women embarking on their first childbirth do not have this advantage. They have high risk of complications, including stillbirth.’

‘During labour, when intervention is needed, it is often needed there and then.’

Severe blood loss that can prove fatal — known medically as exsanguination — can occur in just 10 to 15 minutes in pregnant women, Professor Siassakos added. 

‘A baby can suffer brain injury from low oxygen in 10 to 15 minutes and die within 20 to 25 minutes.’

Both emergencies, blood loss and oxygen deprivation, can be ‘relatively common’, he said. 

‘If they start when women are at home, the time to transfer them to a consultant-led unit for life-saving interventions can take too long, and in excess of the time needed to save mothers, babies, or both,’ he added. 

Professor Bassel Wattar, an associate professor of reproductive medicine at Anglia Ruskin University, also told the Daily Mail that fetal asphyxia — reduction in oxygen flow to the baby — ‘is difficult to monitor at home, unlike in hospital settings where continuous fetal heart rate monitoring is available to detect early signs of distress’. 

He added: ‘If labour exceeds a safe threshold, timely access to medical support is essential for an assisted delivery or caesarean section.

‘Shoulder dystocia — when the baby’s shoulder becomes impacted due to larger size, also constitutes a true obstetric emergency. 

‘Even in hospital settings, it can be complex to manage. 

‘To support women in accessing their preferred birthing environment safely, there must be robust risk strategies and a Plan B in place, ensuring rapid transfer to medical care if complications arise.’

National studies have also shown that just under half of women starting childbirth at home, who have not given birth before, need to be transferred to a consultant-led unit, because they do not progress, the baby is in distress or they suffer bleeding.

‘The key issue is that families need to be aware of key statistics, before making an informed decision,’ Professor Siassakos said. 

‘Homebirth does have many advantages, but these need to be balanced with the risks.

Research also suggests around half of pregnant women in the UK will have or develop a complicating factor — from high blood pressure to diabetes — that makes a hospital birth advisable. 

According to the NHS, home births for women having their first babies can ‘slightly increase the risk of serious problems’ for the baby, ‘from five in 1,000 for a hospital birth to nine in 1,000 for a home birth’. 

Professor Siassakos told the Daily Mail: ‘An almost doubling in incidence of serious complications, including the risk of the baby dying, up to about one in a hundred previously healthy babies, is something that the families should consider and decide whether it is “slight” or significant for them.’

The Royal College of Obstetricians and Gynecologists does also not recommend a planned home birth if women have had a previous C-section, are carrying multiple foetuses or if the baby settles into anything other than a head-first position. 

It comes as Rob Cahill told the inquest into his wife Jennifer’s death yesterday that she opted for a home delivery after finding giving birth in hospital with Rudy in 2021 ‘highly stressful’.

He said: ‘There was no one midwife assigned to Jen. There seemed to be lots of midwives coming and going.

‘Jen did not feel she had been fully supported. It was a tricky time because of Covid and there were lots of restrictions.’

Mrs Cahill had suffered a postpartum haemorrhage after the first birth — a potentially fatal condition involving heavy bleeding.

As a result she was advised to also have her second child in hospital, the hearing was told.

But Mr Cahill said noone had fully explained the risks to them.

The couple believed that warnings to have baby Agnes delivered in hospital were based on the fact that Jennifer had suffered a Strep B infection with her son Rudy, who developed sepsis, he added.

She thought it could be dealt with if it happened again.

Manchester University NHS Foundation Trust — which runs the hospital — has accepted that Mrs Cahill should have been referred to a senior midwife after deciding on a home birth so the dangers could be discussed.

It described the home birth as ‘outside of clinical guidelines’ and says doctors had told her a hospital birth would be safer and preferable.