Home birth questions answered!

You can choose where you birth your baby, so have a chat with your midwife and make sure you’re aware of what your options are; at home, in a hospital, a standalone midwifery unit, even a teepee at the bottom of your garden (yes, I’ve attended a birth there!).  Each pregnancy is risk assessed and whilst those considered to have ‘high risk’ pregnancies (ie complex medical conditions such as pre-eclampsia) are best placed being cared for in a hospital setting, for the majority of women choosing to give birth at home will be an option.

So if you’re considering a home birth read on for our key facts…

How many women choose to have a homebirth?

  • In 2020 2.4% of pregnant women in the UK had a homebirth, and this has remained relatively stable over the last 20 years.  

  • The rate of home births varies a great deal between countries, New Zealand for example has double the UK rate at 4.9% and many European countries see higher numbers, with the Netherlands hitting the top spot for the highest percentage of home births. 

Who can have a home birth?

  • As mentioned previously this will depend on your pregnancy and how much extra support is required.  If you’ve had a straightforward pregnancy and both you and your baby are well then you may want to consider birthing at home.

  • Your home will also be risk assessed to ensure it can safely be accessed etc should you need/want to transfer into hospital

What are the benefits?

  • More relaxed - As you’re in your own home you will likely feel more at ease and this can help the progress of your labour

  • May require less pain relief - Some research has found that women who give birth at home tend to use less pain relief than those in hospital, suggesting birth at home may be more manageable.  

  • Your midwives come to you! - You will have two midwives present during your birth, providing safe one-to-one care

  • Who’s in the room? - You can choose who is present during and after the birth

  • Epidurals and assisted deliveries - These are less likely to be needed 

  • Hospital-acquired infection - risk is reduced

  • Safety (second or subsequent births) - A large UK based study called the birthplace cohort study found that for those women having a second or subsequent baby, home births appeared to have no increased risk of adverse outcomes for babies compared to hospital settings, yet offered benefits for the mother with reduced risks of having a caesarean section, assisted delivery or episiotomy

What are the considerations?

  • Safety (first baby) - the birthplace study found that for those having their first baby at home, there was an increased risk of adverse outcomes for babies with 9.3 adverse perinatal outcomes per 1000 planned home births compared tp 5.3 per 1000 births for those delivered in an obstetric unit. 

  • Transferring into hospital - the birthplace study found that those having a first baby at home had a higher chance of transferring into the hospital when compared to birthing at an alongside midwifery unit (45% vs 40%).  For women having subsequent babies at home this reduced to just 10%.

  • Children - home births can be great as you don’t need to arrange to drop your kids off somewhere when you go into labour.  However, depending on the age of your children it may be useful to have a family member or friend to come to the house and be there to oversee them so you and your birth partner can focus on the birth

Common Questions…

Can I have a water birth at home?

Yes! You can arrange for a pool to be delivered prior to your due date so it’s ready for use with you go into labour

Will there be lots to clean up??

No! Often a large plastic sheet can be popped down making it very easy to wrap up and dispose of following birth.  Your midwife will dispose of the placenta (if that’s what you wish) and any birth equipment so you’ll be left with your house intact and clean to enjoy with your new baby.

Will I know the midwife who delivers me at home?

Most units which offer home births have a specific home birth midwifery team who you’ll be referred to.  Although you can’t guarantee which midwife will be on call when you go into labour, you will have likely met them before at your antenatal checks.

Set some time aside to have a chat with your birth partner and discuss where you’d ideally like to birth your baby.  Remember that having a flexible approach is often helpful as risk assessments are ongoing in pregnancy and your team will want to make sure that you and your baby are well and that the place of birth you opt for is a safe option for you both.

Head to the NHS website and you can access the birthplace study results at the following link for further information https://www.npeu.ox.ac.uk/birthplace/results


 
 
Alice Lewin