Every woman should have the right to give birth at home, according to new guidance from the National Institute for Health and Clinical Excellence.

The guidelines say that for healthy women who have had a normal pregnancy, birth is generally safe whichever place is chosen – at home, in hospital, at home or in a maternity unit run by midwives.

At home or in a midwife-led unit, there is a greater chance of a normal birth with less intervention. But if troubles do arise, the outcome for both mother and baby could be worse than if they were in a hospital with access to specialised care.

The guidelines say that clinical interventions should not be offered or advised where labour is progressing normally and both mother and baby are well. Birthing pools can be valuable to reduce pain.

Nice puts strong emphasis on the need to communicate with mothers before and during labour, and says that women in labour should be given supportive one-to-one care.

In particular, they should be advised before they choose an epidural that it can led to a longer second stage of labour, and needs a greater level of monitoring. It is only available in obstetric units, but it does give better control of pain.

Andrea Sutcliffe, deputy chief executive of NICE, said: “We want to make sure every woman’s experience of birth is as good as it can be and have used the best available evidence to set a national standard on how midwives and doctors can make labour a positive experience for women.

“Currently, the care of women in labour may be varied across the country – these guidelines set the standards of care that every woman should receive.”

Sara Kenyon, who chaired the group that developed the guidelines, said: “Birth is a life-changing experience, but it is also a normal and natural part of life. This guideline respects the normal process of labour and birth and ensures women get the care and support they need.

“The evidence tells us that giving women balanced information and ensuring that they are in control of what happens during their labour, enables them to make decisions that are right for them and their baby. This means they are more likely to have a positive birth experience, and this is important for themselves and their babies’ future.”

The National Childbirth Trust welcomed the guidelines and endorsed the recommendation that women should have the choice of where to give birth. “Giving birth in out-of-hospital settings is generally very safe for both mother and baby,” the NCT said.

Belinda Phipps, its chief executive, said: “We now want to see the health service seize this guideline and implement its recommendations so that services support and promote normality and the best possible care for women and their babies.”

The Royal College of Obstetricians and Gynaecologists said that it welcomed the guidelines but warned that complications during childbirth were unpredictable and could occur even in low-risk births.“For some women, hospitals remain the safest place to deliver” the college said. “Women should discuss the range of options that are available to them, including the risks involved, with their GPs, midwives and obstetricians, so they can make an informed choice.”

— Bearing a son takes so much out of a woman that subsequent children suffer from reduced fertility, a study has shown (Lewis Smith writes).

Fertility levels among siblings with an older brother were found to be significantly lower than among those who were preceded by sisters.

Researchers found that children with an older sister had 12 per cent more children themselves than those with an older brother. They were also 27 per cent more likely to bring up their own children to adulthood. The research was carried out by scientists from the University of Sheffield, who analysed detailed records of births and deaths in Finland between 1734 and 1861. Finns were used for the study because from the 17th century the Church in Finland kept detailed records of births, marriages, deaths and movements between parishes.

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