Can I have a home birth?
Your options for giving birth will depend on your needs, any risk factors you may have and where you live.
Low risk pregnancy
If you have a low risk pregnancy, you may choose to have a home birth where you can remain in familiar surroundings while being supported by a midwife (or two) during labour and birth.
High risk pregnancy
For high risk pregnancies, doctors and midwives usually advise you to deliver your baby in hospital where you can both be monitored more closely. If there is an emergency, the experts will be able to help you more quickly.
Risk factors might include:
- pre-eclampsia or high blood pressure
- a high BMI
- abnormal scans
- a previous caesarean section
- if baby is in the breech position
- if you are pregnant with twins, triplets, or more.
Does it make a difference if I live far away from a hospital?
You should be offered a home birth no matter where you live in the country.
Your midwife will carry out a risk assessment if you have decided to have a home birth, and part of this will be assessing how practical and safe it is if you needed to be transferred quickly.
Benefits of giving birth at home
- You are more likely to be cared for by a midwife that you know.
- If you have other children, you will not need to leave them. But you will need to have arrangements in place in case you are transferred to hospital.
- Your partner will not have to leave you at any point. If you stay overnight in hospital, they may have to go home.
- You are less likely to have interventions such as instrumental delivery or episiotomy.
'Being in an environment I felt safe and relaxed in was so important.' Claire
Things to consider when giving birth at home
For women having their first baby, there is a fairly high chance of being transferred to hospital during labour or after the birth (45 in 100 women). Your chance reduces for second babies after a previous uncomplicated pregnancy and birth (12 in 100 women).
Your midwife will need to do a risk assessment to make sure your home is suitable for birth. They will look at access and check whether you have enough space.
Who will be with you at home?
Other than your midwife, it is up to you who to have with you when you are in labour at home. It is worth remembering that you will need some peace and calmness in your surroundings so you can focus.
Most trusts will also arrange for a second midwife to come to you when the birth is about to happen.
Availability of midwives
Even if you have decided on a home birth, sometimes it may not be possible on the day if there aren’t enough community midwives available. This might be because they are caring for another mum at a home birth.
Taking care of other children during a home birth
It is a good idea to have someone (who is not your birth partner) at home or nearby to look after any other children you may have. You might find it easier to focus on the labour and birth if you know your other children are being well looked after.
This is also important in case you transfer to hospital.
Can I have delayed cord clamping at home?
Most home birth teams will try to do delayed cord clamping (DCC) for every birth as it is now standard practice. Waiting until the blood from the placenta has stopped going into your baby before cutting the cord can increase your baby’s iron levels and the amount of stem cells they have. This can help their growth and immune system.
If you or your baby suddenly become unwell just after birth, the cord may be cut sooner. Your and your baby’s safety during labour and birth is very important and this will always take priority.
Transferring to hospital in an emergency
If you are in labour at home and something seems to be wrong with you or your baby, you may need to be transferred to hospital.
What will happen if I transfer to hospital?
Your journey to hospital will depend on the reason for transferring. Most of the time, a paramedic ambulance will be called for you, especially if you are approaching or in the pushing stage of labour. In the ambulance, you will have access to Entonox (gas and air) for pain relief if you are in labour.
Sometimes, it may be possible to go by car with your midwife following.
In both cases, the midwife will come with you. They may be able to stay and keep caring for you, or another midwife on the ward might take over and look you after.
When you arrive on the ward, you should have a room or bed waiting for you because the midwife will call ahead. If it is an emergency, the team on the labour ward will know you are coming and the obstetric and neonatal doctors will be ready to look after you and your baby.
Pack a hospital bag
You may not need to use it, but you should pack a hospital bag in case.
Are home births safe?
In a recent large study, they found that giving birth at home is as safe as hospital for low risk women having their second or subsequent birth. There is also a lower chance of having an assisted delivery, which could be a caesarean section, instrumental delivery or episiotomy. There is a small increased risk of a poor outcome for the baby of first time mothers.
Pain relief during a home birth
You can buy, hire or borrow a TENS machine. TENS (Transcutaneous Electrical Nerve Stimulation) is a type of pain relief that uses a low voltage electric current. It is a small battery-powered machine with four pads, which stick on your lower back. The pads connect to electrodes that send small pulses of electricity through your skin and into your muscles. Many women use one in early labour.
Some women also choose to have a birthing pool for a home water birth. You can use this for pain relief during the first stage of labour or for delivery if you want to have a water birth. You can buy your own birthing pool, or hire one.
If you cannot afford or would rather not use a birthing pool, you may be able to use your own bath instead. Fill it up to a level you are comfortable with, making sure you’re warm but not hot. This should be fine for pain relief, but you may not have space to move around or give birth in the bath.
Gas and air
Your midwife will be able to offer gas and air at home when you are in labour. They will bring portable Entonox with them and will be available to support you while you use it.
You will not be able to have an epidural at home because it needs to be given by an anaesthetist in hospital.
How to organise a home birth
Each NHS trust has a different way of organising care but if you are thinking about having a home birth at the beginning of your pregnancy, mention this at your first appointment with the midwife or GP. They will refer you to the best person to talk to about it.
If you decide later that you would like a home birth, speak to your midwife as soon as you think it is what you want.
Most trusts will be able to facilitate a home birth if you decide before 36 weeks, unless you have high risk factors, when a hospital will be recommended for the safety of you and your baby.
What do I need for a home birth?
You probably have most of what you need for a home birth already, but here are some things to think about:
- If you’re planning to give birth in your bed, your midwife will bring disposable pads for you to use but you might like an extra waterproof covering for your mattress.
- If you would like a water birth at home, have lots of towels handy as you may want to get in and out of the water depending on how you’re feeling.
- Try to create a calm and relaxing atmosphere that will help you focus. You might like to use music and soft lighting.
- Have a think about pain relief.
- Keep cool using flannels, a spray bottle or handheld fan. If you have long hair you will probably want to tie it up or wear a band.
- Get a birthing ball if you like, but you can use whatever is around you to get into a position that works for you.
- Don’t forget to charge up your phone or camera if you want your birth partner to take photos or video.
- We hope you won’t need it, but it’s a good idea to have something you can be sick in, like a bucket or small bin.
- A handheld mirror if you would like to see your baby's head or what is happening throughout labour.
- Snacks and drinks for you, your birth partner(s) and (if you are feeling generous) your midwives.
- For your drinks, you might like to have a straw to make it easier for you.
'Our midwife suggested just a cheap shower curtain, which was really handy as we were worried about the mattress getting damaged and it was taken away by them afterwards.' Lauren