Nyree Wright, founder of Sage Femme, an independent midwifery practice in London, and a midwife with over 25 years of experience, sits down with us to explain what things to consider when deciding on where to give birth. Here she explains why it is important that you feel safe where you give birth, why your own preferences are not the only thing that matters and the pros and cons of a home birth.
Is the place where you give birth an important decision?
It is important to give birth somewhere where you feel safe. 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, whereas others feel anxious in hospitals and prefer to be surrounded by home comforts.
Are there other factors that will impact your choice of a home or hospital birth?
Where to have your baby is not just about your own preference. You will also need to consider other things, including:
Your partner’s views: If your partner is really worried about a homebirth it could cause a lot of stress, which in turn may impact how will you labour.
Your obstetric and medical history: Depending on your medical history, your obstetrician or midwife may advise against a homebirth. Note that some obstetricians and midwives are not encouraging of homebirth in any situation, regardless of the medical history. 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.
How many babies you have had: National Institute for Clinical Excellence (NICE) does not recommend homebirth for a first baby. First labours tend to be longer and therefore carry a greater risk of you or your baby being too tired to carry on with the labour at home and needing a transfer to hospital. Having said that, I have done many successful homebirths for first babies. In my opinion, with adequate planning and a thorough risk assessment before and during labour, homebirths can be perfectly safe for first babies. For women who have had a previous uncomplicated birth, NICE recommends a homebirth - if labour is progressing very quickly, it is safer to give birth at home where it is planned as opposed to ending up delivering the baby in the back of a car on the way into hospital!
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 do not 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 and also allows them to 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.
Babies are less likely to require resuscitation at a homebirth, as they are less likely to be subjected to unnecessary interventions.
Homebirth can be much better for siblings. They do not 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!
Research also shows that you are more likely to successfully breastfeed if you have a homebirth.
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. In London where I practice, there is usually a choice of several hospitals within sensible distance of home.
If you have a long and traumatic birth at home, the room(s) where you laboured could give you unpleasant flash backs and memories. It is for that reason that I recommend to my clients not to give birth in the bedroom to ensure that this room is not associated with their labour.
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.
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