Choices in childbirth...

Arranging a Home Birth

You don't need your GP's agreement to have a home birth as you can approach a midwife direct. If you don’t know one, write to the supervisor of midwives at your local hospital telling her your expected date of delivery and that you intend to give birth at home. It's her duty to arrange maternity care according to your wishes. There's no need to sign any forms.

You might be asked to see a consultant to discuss it. This can be helpful, but you're not obliged gain a consultant's approval for your choice and some women prefer not to see one.

If you were booked into hospital before you found out about home birth or had time to decide how you feel, you can change your booking at any time during pregnancy. Ask your GP or midwife to arrange it.

Many doctors and midwives are supportive of home birth today, but some remain opposed despite the research evidence. It can be hard to trust your own judgment and stay determined in the face of opposition. Contact AIMS if you need support.

Pros and Cons

• All your antenatal care will probably be at home too. You'll only visit the hospital if you have a scan.
• You can relax in familiar surroundings which may make labour easier.
• There's likely to be less intervention in labour and less risk of infection.
• You'll have privacy and the freedom to do what you like and eat when you want.
• You're more likely to get to know your midwife and once you're in labour she'll devote her time to you alone.
• You can be surrounded by people you love, including your children if you want.
• You can give birth in your own time and in your own way.
• There's extra work preparing before the birth and washing afterwards.
• Labour may be longer as it isn't speeded up artificially.
• There's no technology instantly to hand in case of an emergency. If a problem arises transfer to hospital takes time and can be stressful.
• There's no midwife on hand day and night - you have to phone for advice.
• You may need extra help, especially if you have other children.

Pros and Cons

The Pros

• You may feel more at ease knowing that medical help and emergency facilities are instantly to hand if needed and labour can be speeded up if it's long.
• You meet other mothers, your meals are made for you and you don't have to clean up or do extra washing.
• Midwives are always there to help you care for your baby or answer questions, although if they're rushed off their feet you may not get enough help.

The Cons

• There's not much privacy and you're less likely to get to know your midwife. She may have other women to look after as well as you during labour.
• You may feel you have to conform or please the staff, and you can't do what you like or eat when you want.
• Women have more interventions, need more pain relief and catch more infections in hospital.

Tips

• A water birth at home tends to be more relaxed, with fewer protocols to follow. You could set the pool up a few days in advance to enjoy some family dips.
• Protect carpets with a ground sheet or thick polythene from a DIY superstore or builder's merchant.
• Put an old duvet under the pool liner to soften the floor. Some women mould a beanbag into a chair shape, to lean on.
• In hospital a pool may take about 20 minutes to fill. At home it may take longer, depending on the time needed for the water to heat.
• Wear a t-shirt, crop top or nothing, as you please. The midwife won't get into the pool but if your partner wants to he'll be expected to wear swimming trunks.
• Use a plastic stool for sitting on or getting in and out of the water. A birth ball (obtainable from the NCT) provides convenient seating for your partner or midwife.
• A rubber ring or foam pillow covered with polythene can be useful for support in the pool.
• Have plenty of towels, a towelling bathrobe and dry t-shirts available.
• Any debris (there's usually very little) can be removed with a small sieve.
• Warm water can sap your energy if you're in it for hours, so most women wait until their contractions are as strong as they can bear (usually after 5 cms) before entering the pool.
• A deep bath can also ease pain (put towels on the floor and block the overflow with blu-tack). Or stand in a shower, directing the water on your back or under your bump.