Around one in 50 mums opt for a home birth. So what happens if you decide to have your baby at home, what pain relief can you have and are home births safe? Our expert midwife answers all your questions.

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Your due date may seem a long time away, but it’s never too early to start thinking about where you’d like to give birth.

And you might decide that, rather than go into hospital, you’d prefer to have your baby in the comfort of your own home.

Currently, the NHS says that only 2% of mums have a home birth (in England), compared to around 94% who choose a hospital birth. But, even so, just over one in 50 babies are born at home in the UK.

So if you're thinking about a home birth or have decided to have one and are worrying about aspects of it, panic not.

We've asked Netmums' official midwife Leah Hazard to share her expert advice for anyone thinking about giving birth at home. From who can or can't have one to your pain relief options, here's what you need to know ...

Can anyone have a home birth?

If you have a low risk pregnancy, then a home birth is an option.

Benefits include being in familiar surroundings and you're also less likely to have birth interventions like forceps.

But giving birth at home isn’t suitable for everyone.

Leah says:

‘Anyone can have a home birth; whether anyone should have a home birth is a different question. In the UK, your local health board has a duty of care to look after you if you choose to birth at home.

‘There is ample evidence to suggest that, for most women, home birth is as safe as hospital birth – especially if you are a healthy woman having a healthy pregnancy.

‘However, there are some reasons why your midwife or medical team may strongly suggest that you give birth in hospital.’

Who can’t have a home birth?

If you have a high risk pregnancy, your midwife or GP may recommend that giving birth in hospital is a better option for you.

A home birth might not be suitable if:

• You have a medical condition such as placenta praevia ;
• You have diabetes and are taking insulin;
• If you’re pregnant with twins, triplets or more;
• If your baby is breech;
• If you have high blood pressure or pre-eclampsia .

Leah adds:

‘There are some instances where it may be much safer to give birth with the advantage of immediately available medical staff, neonatal care, medications and blood products.’

Are home births safe?

If you have a low risk pregnancy, yes.

However, according to the NHS , having a home birth ‘slightly increases the risk of serious problems for the baby – including death or issues that might affect the baby's quality of life – from five in 1,000 for a hospital birth to nine in 1,000 for a home birth.’

If this is your second (or more) baby, a planned home birth is as safe as having your baby in hospital.

What if something goes wrong during a home birth?

Usually, you’ll have two midwives with you during your home birth. They will be on hand if any problems develop during your labour.

Leah adds:

‘When things go ‘wrong’ in labour, it’s often a problem that develops gradually over time. Your midwives will be able to advise you if transferring to hospital would be safer, and they will be communicating with the coordinator of your local labour ward by phone if needed.’

According to an NHS Birthplace study, if you’re having your first baby at home there’s a higher chance you may need to go to hospital.

The research found 45 out of 100 women having their first baby at home were transferred to hospital. This dropped to just 12 out of 100 women having their second or subsequent baby needed to go to hospital.

If you decide to have a home birth, when you’re around 34-36 weeks pregnant your midwife will carry out a risk assessment at your house. This includes looking at how quickly you can be transferred to hospital if needed.

As such, it’s useful to have a hospital bag packed with things for you and your baby just in case. Also make sure you ask your midwife in advance which hospital you would be taken to.

How do I organise a home birth?

Speak to your midwife about where you’d like to give birth. This can be as early as your first antenatal appointment.

Before making a decision about where to give birth, Leah recommends reading up on all your options and talking to your midwife, GP or consultant.

What pain relief can I have during a home birth?

According to Leah, you can have a choice of pain relief – including a TENS machine – during your labour.

However, you won’t be able to have an epidural as this can only be given in hospital.

She says:

‘Generally speaking, you are likely to have access to gas and air as well as some kind of opiate injection like diamorphine or pethidine.’

You can also use alternative forms of pain relief such as:

• hypnobirthing
• a birth pool
• massage
• aromatherapy

... all of which can be very effective.

The pros and cons of having a home birth

According to the NHS, the advantages of having a home birth are:

• being in familiar surroundings, where you may feel more relaxed and better able to cope
• not having to interrupt your labour to go into hospital
• not needing to leave your other children, if you have any
• not having to be separated from your partner after the birth
• increased likelihood of being looked after by a midwife you have got to know during your pregnancy
• lower likelihood of having an intervention, such as forceps or ventouse, than women giving birth in hospital

Things to consider before having one include:

• pain relief limitations
• you may need to hire a birthing pool
• you may still need to be transferred to hospital – where is your nearest one? How long would it take to get there?
• it may not be safe to have one (depending on your pregnancy and the position of the baby).

What equipment do I need for a home birth?

Your midwife will bring all the medical equipment needed for a home birth. If you want a birthing pool you’ll need to hire your own in advance.

You’ll need to provide:

• clean sheets and towels
• blankets to wrap your baby in when she’s born
• sanitary mats and pads
• tarpaulins or bin bags to cover your floor, sofa etc
• mattress protector if you want to give birth in bed
• bucket (in case you are sick)
• a torch for your midwife if you want to keep lighting low.

What is the postnatal care after a home birth?

It’s exactly the same as if you give birth in hospital. After having your baby you’ll be visited at home by your community midwives or a dedicated home birth team.

Most midwives will visit until around 10 days. After that, they’ll refer you on to your local health visitor.

Will I still need to go to hospital for newborn checks after a home birth?

Your midwife will examine your newborn just as they would if you’d given birth in hospital. You may be referred to your GP for a more detailed assessment.

You’ll also be given a hospital outpatient appointment for your baby’s routine hearing test.

Planning a home birth with older toddlers and siblings in the house

One of the reasons you might be thinking about a home birth is so you can stay at home with your other children. Yet it’s a good idea to think about who will look after your children while you are giving birth.

Leah says:

‘Some women welcome their other children at a home birth, while others feel safer and more comfortable with their children being looked after elsewhere.

‘Your midwives also need to know that they will be able to store and use their equipment safely without the interference of small, curious hands!

‘Talk to your partner and children about what would work best for you.’

What happens if I have an unplanned home birth?

Very few babies come on time and if your baby starts to make an appearance earlier than expected, the first thing to remember is stay calm.

Leah says:

‘If you have planned to give birth in hospital but your labour progresses much faster than you anticipated, it is best if you or your birth partner can call 999.’

It’s also a good idea to:

• Put towels and sheets down just as you would for a planned home birth;
• Put the heating on so the house is warm ready for your baby’s arrival;

‘An ambulance will be sent to you and paramedics will give immediate care before transferring you and your baby to hospital for initial checks and any other necessary treatment,’ adds Leah.

Did you have a home birth or are you thinking about having one? Chat to other mums about giving birth at home in our chat forum or join in the chat below ...

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