It says this is the case for those who have previously given birth and those who are at low risk of complications.
The authors, from the University of Oxford, looked at 64,000 births between 2008 and 2010 from across England.
Both multiparous women and nulliparous women were included in the study to estimate the cost-effectiveness of alternative planned places of birth.
For multiparous women, planned birth in an obstetric unit was the most expensive option, with mean costs at £1142 per woman with planned birth at home the cheapest at £780 per woman.
For nulliparous women, a planned birth in a midwifery unit compared with planned birth in an obstetric unit was less expensive.
Planned birth at home was also cost saving but was associated with poorer outcomes for the baby.
The research, which forms part of the groundbreaking
Birthplace study, adds further evidence for the argument in favour or midwife-led units and home births.
Louise Silverton, RCM deputy general secretary, said: ‘This, and other research, points out the substantial benefits of midwife-led care; it is better for mothers and babies, it is better for midwives and it is better for the NHS.
‘However, we are still seeing 96% of births taking place in hospitals and this underlines the need to make a fundamental change in the way we deliver maternity services in this country.
‘The government constantly tells us it wants more for less, and this is a shining example of how that can be delivered.’
NICE has previously suggested that estimating the cost-effectiveness of alternative places of birth should be a priority area for research. The study looked at the costs of planned births in four settings: obstetric units, midwifery units located in the same hospital as an obstetric unit, free-standing midwifery units and home.
It assessed NHS costs associated with the birth itself – for example, midwifery care during labour and immediately after the birth.
It also included the cost of pain relief and medical care and procedures, and the cost of any stay in hospital, midwifery unit, or neonatal unit immediately after the birth either by the mother or the baby. The costs for planned home and midwifery unit births took account of interventions and treatment that women and babies received if they were transferred into hospital during labour or after the birth.
The authors conclude that the most cost effective place of birth for multiparous women is at home.
This is also true for nulliparous women, but they stress there is a slightly higher risk of a poor outcome for the baby.
Co-author of the study, Liz Schroder, said: ‘At the time of the study, only half of the NHS Trusts in England provided women with access to a midwifery unit, and occupancy levels were often low.
‘The findings of the
Birthplace study may encourage women – particularly women having a second or subsequent baby – to request an ‘out of hospital’ birth.
‘And the potential for cost savings could make offering women more choice an attractive option for the NHS.’
The study is published on the
BMJ website.
