Home is a very safe place to give birth for all ‘low risk’ women*, and the Birth Place Study (2011) showed that for ‘low risk’ second time mums it’s actually the SAFEST place to be, with less risk of intervention, tearing, cesarean or instrumental birth and a greater chance of a physiological birth. For first time mums there’s a very slight increased risk of complications for baby when giving birth at home.
Once you begin to understand the hormones and physiology involved in birth, you can probably see WHY the rate of interventions are lower, as for most women ‘home’ is somewhere they feel safe, relaxed and unobserved- all KEY for labour to progress. (Which is also why, wherever you choose to give birth, ‘home’ is the environment we want to replicate as much as possible!). Despite this, in the UK, still only around 2% of babies are actually born at home!
Who will look after you at a home birth?
If you choose to give birth at home, you will be looked after by two midwives in labour, who will come to your home at the same stage as when you would otherwise go to the hospital/birth centre. In early labour, you would continue at home in the same way as if you were planning a hospital birth, the benefit of remaining at home is that you don’t then need the adrenalin producing journey to hospital midway through labour! Some hospitals have dedicated home birth teams who will look after you throughout pregnancy and others cover home births through their community midwifery team.
What pain relief options do I have?
If you are planning a home birth, your midwife can bring gas and air. You can also use a TENS machine (which you provide yourself), a Birth Pool (which you can hire or in some areas they can loan them to you), as well as complementary comfort measures such as massage, hypnobirthing, breathing and aromatherapy.
What if there are complications?
For first time mums around 40% of women will transfer into hospital during labour itself (around 10% for subsequent births), however the main reasons for this are because 1) they request an epidural, 2) Labour stalls or slows down or 3) baby passes meconium (their first poo) in the waters. None of these situations are emergencies in themselves, but may be reasons to move to the labour ward. In the same way as a birth centre or labour ward birth, your midwife will be closely monitoring you baby’s heart beat and your vital signs, to keep an eye on any potential complications. Your midwife will bring breathing equipment for baby, should they need it and they are very well trained as to how to deal with emergency situations in the home environment. If you have any questions about ‘what if’ situations or the safety of home birth, chat to your community midwife as early on in pregnancy as you can or request to meet with the home birth team if your trust has one. (Many run ‘meet ups’ where you can find out a bit more without ‘committing’ one way or the other.)
I always encourage women and their birth partners to really consider all their birth place options, and not dismiss one or other based on assumptions or fears, but to gather the information specific to their trust and work out how it applies to them! Whilst facts and figures are important to consider when making your birth place choice, you also need to think about what ‘feels’ right for you. For some women the though of hospitals and doctors sends them into a panic, and home is a natural choice, for others, the idea of being at home doesn’t sit well at all, so gather all your information, but listen to your instinct too!
And don’t forget, you can change your mind at any point about where it is you want to be, but it’s much easier to put in plans to possibly stay at home and then decide to head in to hospital, than it is to decide 5 hours into labour that you don’t want to go anywhere!
*Whilst home birth should be offered to all women with low risk pregnancies, actually even if you pregnancy comes with more complexities, you are still well within your rights to request one. For the purposes of this article I am talking about ‘low risk’ pregnancies, but do discuss the risks and benefits of each birth place with your health care provider and use the Positively Birthing decision making tools to make a birth place choice that feels right for you personally.