Where to give birth: your options
From a hospital to home birth, we explain your choices to help you create a birth plan
When you’re pregnant, you’re pretty focused on the end point, and yet so few of us are actually aware of our choices when it comes to giving birth. So what are your options?
Generally, if it’s not your first time having a baby and you haven’t got any complications (for example a breech baby or twins) or health issues, a planned home birth is as safe as having your baby in hospital or a midwife-led unit.
If you opt for a home birth, you’ll still be supported by a midwife during labour, and it’s more likely to be a midwife you know. You’ll be in familiar surroundings, and subsequently may feel more relaxed.
Women who give birth either in a midwifery unit or at home have also been found to be less likely to require intervention, like forceps.
What you do need to know is how the process of being transferred to hospital would work if it does become necessary and how long this would take – and remember you can’t get an epidural at home!
Pain relief options in labour such as Etonox (gas and air) and opiates like Pethidine are available for home use. However, epidurals and spinal blocks are only available in hospitals as they must be administered by an anaesthetist.
Midwifery unit/birth centre
If you’re not at ease in a hospital environment but it’s your first baby, in which case a home birth is slightly higher risk, then a midwifery unit, or birth centre, may be the happy medium for you.
Birth centres are designed to be a lot more comfortable and homely than a hospital, and you’re more likely to know your midwife. You’re also less likely to need intervention.
However, one thing to consider is the possibility of the maternity unit being full when you go into labour, so you may need a plan B.
Depending on the unit, if it’s completely separate from a hospital then you may not have access to certain kinds of pain relief, like an epidural. Check which facilities they offer – not every maternity unit will have a birthing pool, for instance.
When it's time to go to hospital you’ll have access to a maternity team of midwives, anaesthetists and obstetricians (doctors who specialise in pregnancy and childbirth).
If you know of any complications that may arise during the birth or you’ve had issues during your pregnancy, then a hospital labour ward or midwifery centre are advisable because of the access to help, support and specialists they can offer.
If there are any complications, you’ll have direct access to obstetricians, anaesthetists who can give you an epidural, and special care baby units should your baby need it. However, you are more likely to be looked after by a different midwife than the one you got to know during your pregnancy.
You should discuss your options with your midwife, ideally before you hit 36 weeks, and read as much as possible about your options. The NCT, Birthplace study and NHS are all good places to start. Ultimately, be as open-minded as possible because labour is different for everyone, and things may not go exactly to plan.