Deciding on where to give birth is as individual as your baby and my view generally is that women should give birth where they feel safest. When you feel safe you produce oxytocin and your labour is more likely to progress well with less need for pain relief and unnecessary interventions. Some women feel safe knowing that they are surrounded by medical professionals and technology and if that is how you feel then homebirth probably isn’t for you. Many women though feel safest surrounded by home comforts and feel anxious in hospital so giving birth at home feels very natural and instinctive.
Having a baby at home isn’t just about your preference and you will also need to consider other things. For example, your partner’s views, if your partner is really worried about you having a baby at home it will cause a lot of unnecessary stress which will impact how well you labour.
Your obstetric and medical history obviously have a lot to do with whether it is sensible for you to give birth at home and obstetricians and midwives who are very supportive of homebirth generally may have a view as to whether it is the right clinical decision for you. It is best worked out on a case by case assessment and if there is doubt make sure you have an appointment with an obstetrician or midwife to discuss.
Some obstetricians and even some midwives are not encouraging of homebirth in any situation and if you get the sense that you are not being supported and listened to it is a good idea to book an appointment with a Consultant Midwife at the hospital. The Consultant Midwife’s role is to support women and encourage natural birth so you will get a more unbiased view.
What are the pros of having your baby at home?
- Privacy, comfort, freedom to move around and rest in familiar surroundings. You can eat what you want, when you want and are more likely to be able to get into a relaxed state without the distractions of other people and unfamiliar equipment.
- You don’t have to make the often, difficult decision as to when you should go to the hospital. Your homebirth midwife whether independent or NHS will come and assess you at home and give you the confidence that all is progressing well. If they have concerns and need to recommend that you go to hospital, they will discuss it with you in your own environment giving you a feeling of control over what happens to you.
- A homebirth allows partners to be more involved.They can rest more easily, eat as they need to and have a break with less worry about leaving you as they know that a midwife is with you. In hospital partners often feel in the way and look for a safe place to blend into the background.
- Babies have less need for resuscitation at a home birth as they are less likely to be subjected to unnecessary interventions.
- Home birth can be much better for siblings. They don’t have to have parental separation or the disruption of having to go somewhere to be looked after while you go to hospital. As women often labour at night a sibling often wakes up in the morning to find they have a new sibling.
- It is a wonderful start to a baby’s life, to be born into their own home. I would argue that there is nothing better than the feeling of being tucked up in bed with your partner and your new baby.
- There is less chance of infection which is currently a big concern for many people.
- Research also shows that you are more likely to successfully breastfeed if you have a home birth.
What are the cons of having your baby at home?
- In the unlikely event of an obstetric emergency there may be a delay in getting medical help for you or your baby. For that reason, it is sensible to consider where you live and your proximity to hospitals when making your decision. It is for this reason that NICE (National Institute for Clinical Excellence) don’t recommend home birth for a first baby.You are more likely to need to transfer in if it is your first baby. Not because you are more likely to have serious problems, but because first labours can be too long and you or your baby could end up being too tired. NICE actually recommend homebirth for women who have had a previous uncomplicated birth because it is actually safer to give birth at home if it is planned than in the back of a car if things are happening very quickly. In London where I practice there is usually a choice of several hospitals within sensible distance of home.
- Potentially if your birth is long or traumatic and your birth took place at home it could give you unpleasant flash backs and memories that you would rather not be associated with home. When I discuss homebirth with my clients, I recommend that ideally, they should not give birth in their own bedroom. That way it can be a safe haven afterwards, with nice, clean sheets.
- The mess of a homebirth often puts people off. Although it is an understandable concern it can be avoided with sensible planning. Rolling up expensive mats and duvets. Getting hold of cheap pillows that you are prepared to sacrifice. Your midwives should provide plastic sheeting and disposable bed and floor mats.
I am a big advocate for home birth but it needs to be an informed and individual choice and gathering as much information as you can and discussing it with your midwife and/or obstetrician is absolutely essential. Goto www.homebirth.org.uk for information, research and personal homebirth stories.
