Download Where would you like your baby to be born

Where would you like your baby to be born – home, birth centre or labour ward?
Making the right choice for you and your baby
During your pregnancy you will have to make many decisions about your care. The health care team is there to support you
to make an informed choice about where you would like to have your baby but no one knows better than you what’s right
for you and your baby. The information below will help you to think about where you would like your baby to be born.
Your choice about where to have your baby will depend on the facilities and support you would like for your labour and
the kinds of pain relief you may wish to be available.
We offer women the choice of giving birth at home, in a birth centre or labour ward.
For women with some medical conditions or complications that may affect pregnancy, your midwife or doctor will advise
you that the Labour Ward is the safest place to give birth so that specialists are available if you need extra help during
labour.
The decision about where to give birth is yours and should take into account where you feel most comfortable, relaxed
and in control.
For most women, pregnancy and childbirth are normal life events that are generally very safe and need very little medical
care. In this case you may decide that you would like to give birth at home.
Home birth/birth centre
When choosing to give birth at home or at a birth centre, your care will be managed by a midwife who will support you
through labour and the birth of your baby.
Advantages
• You may feel more relaxed and safer in your home environment or a birth centre.
• Research has shown that a planned home birth for women who are ‘low risk’ is as safe as a hospital birth.
• In most cases you will have met the midwives looking after you prior to going into labour.
• Less disruption to the family with the option to involve other family members if you chose to birth at home.
• More privacy.
• The option to use a birthing pool or hire one if you chose to birth at home.
Disadvantages
• You may require transfer to the Labour Ward if labour does not progress well or there are any concerns about
you or your baby’s wellbeing.
• It may take longer to get emergency treatment for you and your baby.
• Epidural analgesia is not possible at home or at a birth centre.
What do the experts say?
The Birthplace national study published in 2011 was about the risks and benefits of giving birth at home, or in midwife led unit
(which is within the hospital at Frimley and Wexham), or in hospital. The study found women who want to deliver at home, or
in a birth centre is safe for baby, and mothers are more likely to have a normal delivery, especially if you are having your second
or subsequent babies. Women having their first baby at home have a higher chance of transferring to hospital during the
labour.
Home birth is not recommended for women with certain clinical conditions.
During labour 45 out of 100 (45%) women having their first babies require transfer from home to the Labour Ward. You are less
likely to need to be transferred if you have had a baby before. The most common reasons for transfer include concern about the
well-being of the baby, for further analgesia or a long labour.
After the birth there is still a small chance you or the baby may need to go to hospital. Your midwife will have discussed potential
problems with you and your partner prior to your baby’s birth.
Labour ward birth
If you decide to give birth on the Labour Ward, your care can be managed by a midwife or a maternity team comprising of a
midwife and obstetrician. A paediatrician, an anaesthetist and sometimes other specialists will be available if required.
Advantages
• There is a wide choice of pain relief available including a 24 hour epidural anaesthesia service and a birthing
pool.
• If you do not have a medical complication you have the choice to have your baby in the birth centre,
which is a home from home environment led by midwives.
• Medical help and emergency facilities are close by.
• Facilities are available if you have special needs such as interpreters, adjustable beds and wheelchair access.
• You will meet other women having their babies.
Disadvantages
• You are more likely to have interventions such as electronic monitoring and drips.
• You may not have met the midwife looking after you prior to going into labour.
• Separation from other family members.
What do the experts say?
The Birthplace study has evaluated the evidence relating to hospital maternity units and states that:
• Birthing on the Labour Ward is recommended for women with certain medical conditions.
• You are less likely to have a normal birth, than if you chose to give birth at home, or in a birthing centre.
You decide
• Don’t feel you have to rush into a decision.
• Take your time and discuss it with your family and midwife, who will be able to give you more detailed information.
• Remember that you can change your mind at any stage during your pregnancy.
• Try to keep an open mind, so that you can alter your plans if your needs change.
Suggested further reading
Birthplace in England Research Programme (2011) The Birthplace Study Available at: www.npeu.ox.ac.uk/birthplace
Kitzinger,S.(2002)Birth your way. Dorling Kindersley Publishers Ltd, London. ISBN-13:978-0751307887
National Childbirth Trust NCT booklet-Home Birth: All you need to know www.nct.org.uk/birth/choosing-where-have-your-baby
National Institute for Health and Clinical Excellence (2014) Intrapartum care: care of healthy women and their babies during
childbirth (quick reference guide) NICE, London available at: www.nice.org.uk/guidance/cg190/chapter/Introduction
Updated by: A Roberts, G Mackey
Department: Maternity
Frimley Health
Last reviewed: July 2015