Home Birth

Is it Safe?

Naturally this is the biggest question for women considering a home birth. The question of safety is a contentious one, and relies somewhat on individual circumstances. However, in general, midwives and obstetricians agree that a home birth is just as safe as a hospital birth for women whose pregnancies are going well. Home births are only recommended for low risk women. If you have had problems during your pregnancy, or your last birth involved complications, it may be risky to try a home birth. However, the final decision should be down to you no matter what the doctor has recommended.

Many women who have home births get transferred to a hospital anyway, usually because the labour is taking too long or because they need pain medication such as an epidural. This figure is about one in seven. However, in rare cases transferral to hospital is urgent due to unforeseen complications. In this instance, how far you live from a hospital can make an enormous difference, so it is worth considering this as a safety aspect before you plan a home birth.

Why Have a Home Birth?

Lots of women opt for home births and the reasons vary enormously, but for most the appeal is that home births seem more natural. There are fewer interruptions, less medication and less machinery, which is a great advantage to many women. Many women actually feel safer having the baby at home, and midwives and obstetricians believe that how the woman feels is just as important as hers and the baby’s physical health. In your own home you may feel more in control; you are able to eat and drink when you want in a familiar environment with your family close to you. You are also less likely to be exposed to unfamiliar germs.

Organising a Home Birth

In theory, anybody can opt for a home birth. However, in reality, there may be logistical problems which prevent you. You should only be recommended a hospital birth if there is a clear, medical reason. However, in some areas where there is a high shortage of midwives, hospital births may be prioritised at the expense of home births. If you live in the more remote parts of Scotland or Northern Ireland, home birth may not be an option at all. These are the realities for those looking to organise a home birth.

However, in most cases you will be asked early on in your pregnancy where you want to give birth. You should tell your midwife or GP during one of your antenatal appointments. Your choice will be recorded, and at a later stage your midwife will give you instructions on how to prepare for your birth. If you prefer, you can book an independent midwife, though this costs money. The cost depends on where you live and what package you choose, but varies from £2000 - £4000.

How Common are Home Births?

The statistics around home births vary depending on region. More women want a home birth than actually get one, but equally some women end up having a home birth by accident and probably unaided. This happens most often when the pregnancy was a secret, or in the rare cases where the woman did not know she was pregnant. However, as a guideline, in England three in every hundred births are done at home, in Scotland it is one in a hundred and in Northern Ireland the figure is as low as one in every two hundred. Most women choose hospital births because in some ways it is easier, and it has become the norm, but this should not put you off having a home birth if you want one.

Who Will be at a Home Birth?

In terms of professionals, there will usually be two midwives involved in a home birth. These are usually community midwives. One will guide you through the early stages of labour, and may stay with you the whole time but may come and go. Ideally there will be two midwives present at the actual birth of the child.

As for friends and family, of course your birth partner will be present. You can discuss who else you want to be present with your GP or midwife, but you must be sensible about how much space there is, and only invite people who will comfort you rather than annoy you. It is probably inappropriate for young children to be present, but one of the advantages of the home birth is that they can be in the next room.

What Equipment is Needed?

Home births are usually very natural affairs, so there is no need for any heavy duty hospital machines. The midwife will probably bring his/her kit round a few weeks before your due date. You should keep this handy, along with the following items:

• Plastic sheeting to protect your flooring and furniture in the birth room.
• Old towels to cover the plastic sheeting.
• A warm blanket in case you get cold.
• A bucket or bowl in case you are sick during labour.
• A baby blanket and maybe a portable heater for once the baby is born.
• A desk lamp (with access to a plug socket) so that the midwife can inspect you for any tears after the birth.
• Bin liners to tidy up.

You should still have a bag packed in case you need to go to hospital during your labour, and this should contain comfy clothes, toiletries and pyjamas. Other than this, you can design your own home birth and make your home into exactly the kind of environment that suits you best.

What Happens if Something Goes Wrong?

If there is an emergency during your labour, the midwife should be able to spot it early and get you to a hospital. Big problems cannot be dealt with in the home. Similarly, if halfway through labour you decide you need stronger pain medication, or if labour is simply taking too long, you may be taken to hospital.

Can I Change My Mind?

You can change your mind about your home birth at any time during your pregnancy or labour, except of course if the baby is due imminently. If you feel towards the end of your pregnancy that you would feel safer in a hospital, it is wise to change your mind.

Where Can You Have a Home Birth?

You should be able to have a home birth in any size home, including small flats. Most doctors and midwives only require you to have electricity and running water. Other than that it should not matter where you live. Obviously if you have neighbours that live very close it is probably a good idea to warn them that you will be giving birth at home.

Is Home Birth Messy?

Of course births in general are fairly messy. However, home births are often less messy than hospital births because there are fewer antiseptics and fewer procedures which cause bleeding, such as episiotomies. Any mess should be caught in plastic sheeting which can then simply be thrown away.

Can I Have a Water Birth at Home?

Water births are increasingly popular because they are said to relieve some of the pain without the need for medication. They are available in all birth settings, including home births, but obviously you must either have a bath, or the space to accommodate the birthing pool. All these options must be discussed with your doctor and midwife, and should not be attempted on your own.

What Happens After the Birth?

After the placenta has been delivered, the midwife will check you for tears, and give you stitches where they are needed. If the placenta is not delivered, or if you have a very severe tear you may need to go to hospital. If everything runs smoothly, you will probably be given a quiet moment with your new baby before the midwife takes him/her to be weighed and checked over. The midwife will help you with the first feed and stay until you feel comfortable and well before clearing up any mess and leaving. You will then have regular visits from the midwife for a short while after the birth, and regular check ups with your GP.