Over the next few blogs I want to take a look at the various types of locations and deliveries a Mum-to-be can expect. I will then look at the some of the ways Mum can aid her recovery, whilst caring for a newborn. In today’s blog, I will outline the options, and then discuss in more detail the benefits and limitations of a Home Birth.

‘The birth of a child should be a wonderful, life-changing time for a mother and her whole family. It is a time of new beginnings, of fresh hopes and new dreams, of change and opportunity. It is a time when the experiences we have can shape our lives and those of our babies and families forever. These moments are so precious, and so important.’

Baroness Julia Cumberlege, Independent Chair of National Maternity Review

New Life is Precious

From my own two birthing experiences I couldn’t agree more with Julia Cumberlege.  Each one was different; I learnt from the first and during my second one I felt more in control and able to express what I really wanted.

Today most women are starting their families at an older age. A lot more women have more complex health needs that could affect their pregnancies, their well-being and that of the baby.  Studies and reviews (such as the one above carried out by Baroness Cumberlege) have shown that many women aren’t being offered real choice in the services they have access to. Instead many are being told what to do, rather than being informed so that they can make the right decisions. 

Do Your Research

Remember ‘informed knowledge is power’. There is nothing more demoralising than feeling you don’t have control over your body and what does or doesn’t happen for you and your baby.

The studies/reviews are out there, you only have to google and you have the information right at your fingertips.  Information that will help you understand what will happen during your pregnancy, birth and beyond. Information that, once learnt, will enable you and your partner to have an open discussion with your Healthy Care Provider (HCP) on suggestions, recommendations and plans for this magical journey you are both embarking upon.

HCPs are brilliant and passionate about their professions, but each pregnancy is different. Each Mum is different. So it isn’t wrong to question what you are being told. But in order to do this you need to be informed… don’t just leave it to the professionals.

Okay so we know well informed knowledge is power, here comes the information.  First up, let’s take a look at the childbirth locations before moving onto the types of delivery open to Mum.

Where to Give Birth

Childbirth delivery options can take place at home, in a birthing centre or in a hospital. Options about where to deliver will depend on your needs, risks and, to some extent upon your location. If Mum is healthy and is deemed ‘low risk’ then Mum can consider any of the above birth options. For example, a Mum giving birth at home or in a birthing unit is less likely to require assistance, such as forceps or ventouse (I will explain these methods later.)

However, for those Mums with medical complications the safest place to deliver would be in hospital, because of the specialist care readily available. If any complications should arise, these can be implemented immediately.

Find out Your Options

Your midwife will discuss all the options available in your local area.  As well as your midwife, check out the following valuable sources of information:

  • children’s centres – find a children’s centre near you
  • your GP surgery
  • local maternity units – find maternity services near you
  • Maternity Voices Partnerships (MVPs) – ask at your local hospital’s maternity unit
  • the Birthplace study – published in November 2011, this compared the safety of births planned in different settings
  • Check out family and friends for their advice and feedback

Choosing What’s Right For You

The benefits and risks of each delivery option must be weighed up, alongside the mother’s preferences, so what is right for her and baby can be determined.

According to the Office for National Statistics (released 2018,) over 755,042 babies were born in 2017.  That’s a lot of babies! Each with different decisions to be made, and birth locations and methods to choose from.  Whatever Mum does decide, her choice, method and location should feel right to her. Remember these decisions are not set in stone and can be changed at any point during the pregnancy!

So what is the difference between a Home Birth, Midwifery Unit / Birthing Centre, and Hospital delivery? In this Blog, I will be focusing on the option of a Home Birth, and in the next few weeks discussing the other options too.

Home Birth

If your pregnancy is straightforward and both you and baby are in good health, you may decide to have the birth at home.  Just over 1 in 50 pregnant women give birth at home. Generally speaking giving birth is generally safe wherever Mum chooses to have her baby.  However, for women having their first one, a home birth slightly increases the risk of problems for baby from 5 in 1,000 for a hospital birth to 9 in 1,000 for a home birth.

For a second time Mum or subsequent baby, a planned home birth is as safe as having your baby in a hospital or birthing centre, led by a midwife.

If you decide on a home birth, you will be supported by a midwife who will be in the home whilst you are in labour and delivery.  In the event that Mum needs help or the labour isn’t progressing as well as it should be, then the midwife is able to make the necessary arrangements for a transfer to a hospital.

So what are the advantages of a home birth? 

These include:

  • familiar surroundings; Mum will feel more relaxed and better able to cope
  • no interruption to Mum’s labour to leave for the birthing centre or hospital
  • not needing to leave your other children
  • no separation from your partner after the birth
  • increased likelihood of being looked after by a midwife you have got to know during your pregnancy
  • less chance of having an intervention, such as forceps or ventouse, than other Mums delivering in hospital

Points to consider when choosing a home birth:

  • Mum may need to be transferred to a hospital if complications occur.  The Birthplace study found that 45 out of 100 women having their first baby were transferred to hospital.  Compared to 12 out of 100 women having their second or subsequent baby.
  • Gas and air, a warm bath, a birthing pool, TENS, plus any relaxation method Mum may of learned (these I discuss in delivery methods and options) are available in the home but Epidurals are not.
  • Your HCP may recommend delivery in hospital and will provide explanations as to why they think a hospital birth is safer for Mum and baby.  For example, if Mum is expecting twins or if the baby is lying feet first (breech). It is the job of a doctor or midwife to adequately explain about what would happen if Mum has to be transferred and how long that transfer would take.

Planning a home birth:

So in conclusion, ask your doctor or midwife if a home birth is suitable for you and your baby.  If it is – great! From here, your midwife will arrange for members of the midwifery team to help and support you.  Here are a few questions you may like to ask.

  • What things can I do to manage my pain at home?
  • How do I prepare my home for giving birth?
  • How do you monitor me and my baby during labour?
  • What equipment do you bring to my home in case of a medical emergency?
  • What issues or changes would require my transfer to hospital?
  • How long would it take if I needed to be transferred to hospital and how would I get there?
  • What is the process for booking a hospital for back-up?
  • Do you have a relationship or collaborative arrangement with the hospital I would be transferring to?
  • If I need to transfer to hospital, would you come with me and what would your role be?

Next time I will be looking at why choose a Midwifery unit, more commonly known as a Birth Centre and Hospital. If you have any questions, get in touch and we will be happy to help.

Happy Body, Happy You, Happy Baby!

References:

  • NHS.UK
  • National Maternity Review 
  • Office for National Statistics
  • Better Health
  • Medicine Net