The following information is taken from 'Home Sweet Home', a home birth information leaflet, developed by the Home Birth Reference Group, and part funded by Heads of Midwifery and Bounty, to give newly pregnant mothers the information they may need to help them choose the best place to give birth.
Why home birth?
Birth is one of the most important events in a woman and her partner's life. The birth of a baby is a family event. However, it often occurs outside the family environment.
There are a variety of reasons why individual women choose to give birth at home, and many factors may influence this:
- birth is seen as a natural process
- giving birth is a family event and home birth allows other family members to be involved
- home is more relaxing and intimate, and allows privacy
- some women dislike or see no reason to go into hospital
- it avoids separation from partner or other children
- it provides the opportunity for a gentler introduction to a new baby for other children
- it offers greater continuity of care from a midwife, reducing conflicting advice
- women want more involvement and control, and have confidence in their natural ability to give birth
- it avoids unnecessary interventions
- it reduces the chances of infection.
There is no one type of woman who has a home birth.
"In the house it was brilliant, comfortable, relaxing, everything in your own environment - it calms you and you can just focus on what you've got to do not what's going on around you. It's just what you've got to do and that's it.""It was just so lovely and calm. The curtains were closed, it was a lovely day, we had a bit of music on, it was so relaxed."
Is it safe?
There is no evidence to support the claim that the safest policy is for all women to give birth in hospital.
There is a great deal of evidence that a planned home birth improves the overall outcome for both the mother and baby.
Research over the last couple of decades suggests that home birth is at least as safe as hospital birth for healthy women with normal pregnancies.
Studies have shown that women with healthy pregnancies who had a planned home birth had fewer complications, medical interventions, inductions, episiotomies and caesarean sections that those who gave birth in hospital.
"If there had been a risk factor I would have gone in. I was not going to hang on to the bed post!"
Who is suitable for home birth?
Provided that you are healthy and your pregnancy is normal, it should be safe for you to give birth at home.
If you would like a home birth, talk to your midwife who will be able to discuss all the options that are available to you.
You do not have to make a firm decision about home birth at the beginning of your pregnancy, although a decision prior to labour is advisable so that adequate preparations can be made.
You can change your mind at any time.
Who needs to be there?
Midwives provide all care for women who plan a home birth.
Midwives are the experts in normal birth and are trained to recognise signs of complications and to refer the woman to a hospital if necessary. Your midwife will tall you how to contact her and her team once you think your labour has started and she will be there to support you throughout the labour and birth.
Many midwives will call on a colleague to come to the home once birth is imminent so that help is at hand should it be needed. Apart from this, it is your choice who is present. You may want your partner, a friend or other family members to be with you. Talk to your midwife and family and discuss what support you would like from each person.
Family doctors do not normally attend home births. If additional care is needed for delivery then it is given in the hospital by specialist staff. Many midwives encourage home births. If you feel that your midwife does not support you then you can discuss this with the supervisor of midwives at your local hospital.
"I didn't know the midwives that came here because they were different ones on call, I'd never met them before but it was like I'd known them for years.""The midwives were friends as well, that was nice, you felt that they were really pleased for you."
Partner's and family's role
You may need some help and support in preparing for the home birth, and once you are in labour you will probably want to have family help at hand.
If you have other children it is wise to make some arrangements to ensure that someone is available to look after them when your labour starts, leaving your partner to concentrate on supporting you.
If your children are staying at home, talk to them about what they can expect - who will be coming and what noises they may hear! Your partner will have a clear role once you are in labour and will be of great help to the midwife in knowing where everything is.
"I'll never forget it, it was really nice and the children, well, I think they took to him because they were involved from the start."
Pain relief available for home birth
"It was much less painful for me. I'm sure it was because I was at home because I was so relaxed about it."
Women who give birth at home consistently value the experience as less painful than a hospital birth. This may be because they are more relaxed and feel more in control.
You may find it helpful to discuss how you could best manage the pain of labour. In early labour keeping busy by going for a stroll or just carrying on what you would normally be doing are useful strategies.
Once labour progresses different positions and movement as well as warm baths and relaxation techniques all help. Some women use complementary therapies such as massage or acupuncture. TENS machines may be available but you will need to make sure by talking to your midwife before the labour begins. Entonox (Gas and Air) will be available, and should you feel that you may need further analgesia then discuss with your midwife antenatally.
"I considered pethidine I had it there just in case, I ordered it, but you know I didn't need it. I thought 'no I'm OK it's not that bad'."
Practicalities of a home birth
"I thought it's easier, more practical and convenient and much nicer afterwards."
There is not a lot of preparation for home birth, and although many women worry that there will be a lot of mess, this is not the case. Your midwife will chat with you about what you need to do.
"I guess I'm quite proud of myself as well that I did do it. I'm pleased I had one, pleased that I had a home birth."
History
Prior to the 1950s the majority of women gave birth at home.
Government policy and medical opinion instigated 100% hospital birth during the early 1970s.
Now, up to 98% of women give birth in hospital, but this trend is slowly changing as more women appreciate that with increased midwifery and medical knowledge, home is a safe alternative to hospital for the majority of women.
