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Where can I give birth?

When you go to your first appointment with your midwife, or even when you call to let them know you’re pregnant, often one of the first questions you’re asked is where you want to give birth. If you’re in the early weeks of pregnancy, this might not be something you’ve even considered yet – being pregnant is mind-blowing enough, let alone considering birth options. But, it is your choice where you birth and you have a number of options. Whilst generally, people tend to chose one of the following three, if you decide you’d like to birth anywhere else, that is your choice and right to do so. Also, it is also more than ok to change your mind and switch during your pregnancy.

Ok, so what are the top three options?

1) Home birth – having your baby at home

Anyone can choose to birth at home, however, in some circumstances your midwife or hospital trust may advise against it. For example if you or baby are unwell, or if you have had any complications during pregnancy. But, even if this is the case the choice is still yours and it is worth getting informed and discussing options further if you think you’d prefer to be at home. It’s a great choice if a more medical environment is not for you.

In a homebirth, a midwife can come to your home to assist you with the birth of your baby. Just before your baby is born a second midwife will also arrive. For a homebirth there are a number of pain relief options available; you can hire a birth pool, gas and air is available via your midwife and some pharmaceutical pain-relief may be available dependent on your hospital trust (but not for example an epidural, you would need to transfer to hospital for this).

Contrary to popular belief, research has shown that homebirth is safe, with a reduced likelihood of postpartum haemorrhage, episiotomy, 3rd/4th degree tears, instrumentally-assisted birth (e.g. forceps), caesarean and epidurals. So, it’s definitely a valid option to explore further.

2) Midwife-Led Unit

Birth centres or midwife-led units are a cross between a homebirth and hospital birth, the environment is designed to be more home-like (think soft lighting, and cosier surroundings). You will have a room with an ensuite and in some units rooms include birth pools (the number of rooms with birth pools varies from unit to unit). The units can be attached to a hospital or ‘free-standing’, separate from the local hospital. The units are ‘midwife-led’ and you will have a midwife supporting you through your birth.

For pain relief, in addition to the birth pool you will be able to access gas and air and some pharmaceutical pain relief. But, you would have to transfer to hospital if you wanted to have an epidural or needed further medical support from a doctor. Following your birth you may be able to stay in the birth centre for some time, go directly home or be moved to a postnatal ward.

Generally, if you and baby are well you can access a birth centre/midwife-led unit. However, some units have policies and criteria around who can birth there. For example, if you are deemed ‘high-risk’ for any reason it is likely that it will be recommended you birth in a hospital maternity unit. However, it is worth discussing your individual circumstances with a Professional Midwifery Advocate, or the Lead Midwife for the unit you wish to birth in.

3) Hospital Labour Ward or Delivery Suite

If you or baby are unwell, or if you have had any complications during your pregnancy it is likely that you will be recommended to birth in a hospital delivery unit. In this unit you will be supported by a midwife, but also have access to consultants, anaesthetists, surgeons and neonatologists (specialists in newborn care) if required. Also, if you require a caesarean, or are planning an induced birth this is where you are likely to be supported to birth.

When birthing in a hospital unit, you may be on a shared ward in the early stages of your labour (depending on when you go into hospital), but will be moved to a delivery suite when your labour progresses (a private room, generally with an ensuite depending on your hospital). Following birth, you may go home directly from the unit, or be moved to a postnatal ward.

Within a hospital maternity unit, you may have access to a birth pool and you will be able to access pharmaceutical pain relief (including an epidural). However, research shows that you’re also more likely to have an epidural, an episiotomy or a forceps/ventouse delivery.

So, what do you think of the options above? It’s worth doing some more research and chatting through your options with your birth partner, friends or family to figure out what’s right for you. If you want to find out more about your birth choices, whether that’s where to give birth, or what pain-relief options are available, then take a look at my upcoming hypnobirthing courses. I support parents-to-be in person in Cambridgeshire and online. Two courses are available ‘Hypnobirthing’ and ‘Birth After Caesarean’ if you have had a previous caesarean birth and want to focus specifically on elective caesareans and vaginal birth after caesarean (VBAC).

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