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Sir,

In your recent editorial, you commented that ‘It seems strange that the government of a major developed country should be encouraging a substantial return to home births without commissioning a major prospective study of its safety, and the practicality of providing the increased numbers of midwives that would be needed to implement it’.1 You may therefore be interested to know that a major national prospective cohort study is currently being carried out to evaluate safety and cost-effectiveness of planned place of birth as part of the ongoing Birthplace in England Research Programme (Birthplace).2 Birthplace is funded by the English Department of Health Policy Research Programme and the National Institute for Health Research Service Delivery and Organisation Programme (NIHR SDO).

The Birthplace cohort study will compare clinical outcomes for 17 000 births planned at home, 10 000 planned in freestanding and alongside midwifery units and 30 000 births in obstetric units. A concomitant study of staffing is being conducted to allow economic analysis of service provision.

The fact that midwives are prepared to integrate data collection for Birthplace into routine care and thereby providing evidence to inform policy bears testimony to the extent to which they value asking questions about planned place of birth.

Footnotes
  • *

    The members of Birthplace in England Research Programme Co-investigator Group are as follows: Rona McCandlish (Epidemiologist, NPEU, University of Oxford), Peter Brocklehurst (Birthplace Programme Lead, NPEU), Rona Campbell (Professor of Health Services Research, University of Bristol), Mary Logan (Project Manager, Birthplace Programme, NPEU), Alison Macfarlane (Professor of Perinatal Health, City University), Christine McCourt (Professor in Anthropology and Health, Thames Valley University), Alison Miller (Programme Director and Midwifery Lead, CEMACH), Deirdre Murphy (Chairman of Guideline and Audit Committee, Royal College of Obstetricians and Gynaecologists), Mary Newburn (Head of Policy Research, National Childbirth Trust), Stavros Petrou (Senior Health Economist, NPEU), David Puddicombe (Researcher, Birthplace Programme, NPEU), Maggie Redshaw (Social Scientist, NPEU), Rachel Rowe (Researcher Birthplace, NIHR Award Holder, NPEU), Elizabeth Schroeder (Health Economist, NPEU), Jane Sandall (Professor of Midwifery and Women’s Health, King’s College London), Louise Silverton (Deputy General Secretary, Royal College of Midwives), Mary Stewart (National Lead Midwife, Birthplace Programme, NPEU) and Neil Marlow (Professor in Neonatal Medicine, University of Nottingham)

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