Introduction
Choosing where you would like to have your baby is a big decision, so it’s important to make an informed choice about what’s best for you both.
Here you can find the answers to the most commonly asked questions, as well as information about home births.
You may want to make some notes and jot down any thoughts, preferences or questions you have to discuss with your midwife.
Who can have a home birth?
Everyone has the option of choosing a home birth – even for your first baby. However, there are instances when a home birth may be unwise, for example, if there are concerns about a condition you may have.
Your midwife or doctor can discuss any risk factors with you
Choosing a home birth – the advantages
The advantages to a home birth are mainly personal reasons, such as:
- It feels right for you
- Feeling safe, secure and in control
- Less disruption to family life, especially other children
- More privacy
- A more relaxed environment
Who will be there?
A midwife will come to you if you choose to have a home birth. They are experts in normal pregnancy, birth, and care of you and your baby following birth.
The Community Midwives work in a team and will provide your antenatal, labour and postnatal care. However, the midwife on duty when you go into labour may not be someone you know, as the team take it in turns to be on duty.
We make every effort to accommodate home births, however at times of high demand or staff shortages, a Community Midwife may not always be available.
Is it safe?
Evidence from research suggests that healthy women who are at low risk of complications, are more likely to have a normal birth when birth is planned at home compared to hospital.
If you’re expecting your first baby, and have a low risk of complications, we would advise you to plan to give birth in a midwifery-led unit.
If you’re expecting your second, third, or fourth baby, and you’re at low risk of complications, we would advise you to plan to either give birth at home or in a midwifery-led unit. This is because the rate of interventions is lower and the outcome for your baby is no different to an obstetric unit.
For women expecting their first baby, 67% who planned a birth at home had a normal vaginal delivery compared to 46% who planned a hospital birth.
For women expecting their second, third or fourth baby, 96% who planned a birth at home had a normal vaginal delivery compared to 70% who planned a hospital birth.
For women expecting their second, third or fourth baby, and who are at low risk of complications, the outcome for baby is better when birth is planned at home.
Two per 1,000 babies both at home, compared to three per 1,000 babies that were born in hospital, needed extra care and treatment.
There are lower rates of interventions, and many women report feeling much more satisfied with their birth experience at home when compared to a hospital birth.
The perinatal mortality rate (stillbirths and deaths of babies in the first few weeks of life) is significantly lower in planned home births.
What pain relief can I have?
Women who labour and deliver at home report needing fewer drugs for pain relief. They tend to be more relaxed, feel in control and are able to cope with the pain of their contractions.
You will have access to Entonox (gas and air) which will be brought to your house by your midwife. You may wish to consider non-drug methods of pain relief, such as TENS (Transcutaneous Electrical Nerve Stimulation). This uses a mild electrical current to block the pain receptors in your central nervous system.
Relaxation, breathing techniques, staying active and changing position regularly can also help to reduce your perception of pain.
If you would like to have a water birth at home, this is something that can be arranged. Our Community Midwives are trained to care for you if you choose this option and birthing pools are readily available to buy or hire.
Choosing a home birth – the disadvantages
Whilst still uncommon; for women having a first baby, a planned home birth can increase the chance of a poor outcome for baby.
Nine per 1,000 babies born at home compared to five per 1,000 babies that were born in hospital needed extra care and treatment. It is not yet known why this occurs.
If any complications develop for you or your baby, it is advised to transfer to hospital by ambulance. In an emergency situation, Community Midwives have the equipment and training to carry out some emergency care, however the transfer time may delay access to some forms of emergency treatment, depending on how long it takes to get to the hospital from where you live.
The Birthplace study (2011) showed that for women having a first baby the transfer rate was 45% compared to 12% for women having a second or subsequent baby.
The most common reasons for transfer from home to hospital during labour are:
• The need for improved pain relief
• Delay in labour (at any stage) 32.4%
• Meconium liquor. When baby has opened their bowels in labour this can be a sign that they are in distress, your waters could appear brown or green in colour 12.2%
• Concerns about the fetal heart 7%
Choosing a hospital birth
Within our Trust we are able to offer Midwifery care in labour at either one of our two consultant hospital units (Grimsby and Scunthorpe) or our midwifery unit (Goole Hospital).
Birthing pools are available at all three units.
There is access to all types of pain relief, including an epidural (this is not available at Goole midwifery unit) and extra equipment and monitoring are available should the need arise.
If an emergency situation occurs there is 24 hour consultant cover within the Grimsby and Scunthorpe units.
If you are considered to be at risk of complications during labour or birth, we advise you to plan to give birth in an obstetric unit. This is so there is access to monitoring equipment, obstetric doctors and anaesthetics.
Your choice
Choosing where to give birth is important. When you make your choice, remember:
- You are not only choosing the place of birth. Often you are choosing who will be with you and the type of care you and your baby will get
- You should give birth where you feel safe, comfortable and relaxed
- You do not have to make a decision now and after you make a decision you can always change your mind at any time during your pregnancy
- You have the right to give birth in the place of your choice. If you are advised not to give birth in the place of your choice, ask the doctor or midwife to explain the benefits and risks for you and your baby
How do I arrange a home birth?
Speak to your midwife who will be able to discuss home birth with you in more detail and answer your questions. She will also discuss the practicalities with you.
If you are struggling to have your care choices met and / or where a planned home birth is considered to be against medical advice, your midwife can create a personalised care plan with you that takes in to account any additional risk factors and additional care that may need to be planned for.
How do I find out more?
If you would like to talk more about the different places you can give birth, you can discuss this leaflet with your midwife or doctor.
How can I get in touch?
You can call our Community Midwives on:
Grimsby 03033 305232
Louth 01507 600100
Barton 03033 306860
Brigg 03033 306860
Scunthorpe 03033 303088
Isle 03033 306744
Goole 03033 304079
References
Birthplace study (2011) Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study www.npeu.oc.ac.uk/birthplace
CEMD (Confidential Enquires into Maternal Death) (2008) Perinatal Mortality 2006 Coxon (2014) Birth Place Decisions. www.nhs.uk
NCT (National Childbirth Trust) Briefing: Home Birth (2008) policy. [email protected]
NICE (2014) Guideline CG190 for Intrapartum Care
www.nice.org.uk/guidance/cg190
NMC (National Midwifery Council) (2012) Midwives Rules and Standards.
RCOG (Royal College of Guidelines) / RCM (Royal College of Midwives) (2007) Joint Statement: Home Births.
(2004) Department of Health (DoH) National Service Framework for children, young people and maternity services. London. Stationery Office.
(2005) Place of birth: Informed choice leaflets, MIDIRS, Bristol at www.infochoice.org
Any comments, compliments, concerns or complaints?
If you have any other concerns please talk to your nurse, therapist or doctor.
Our Patient Advice and Liaison Service (PALS) is available on 03033 306518 (Grimsby,
Scunthorpe and Goole). You can also contact [email protected]
As a Trust we value equality of access to our information and services, therefore
alternative formats are available on request at nlg-tr.interpreters@nhs.net
Review information
Date of issue: June, 2022
Review period: June, 2025