Thinking about having a home birth?

Our midwife has drawn up an essential checklist that will help you decide if it’s going to work for you

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Staying in your own house with your partner, the midwife coming to you, being in your own bed the night after you give birth… 

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If you’re expecting and want to be one of these mums, you might wonder how you go about getting a home birth. Do you need permission from someone official? Does your home need to be checked for suitability? Could your health be an issue? All these questions and more are probably running through your head, which is why I’ve come up with this simple checklist to make coming to your decision a whole lot easier. Work through each section before you make your birth plan.

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All antenatal classes will help you and your partner prepare for the birth.

Consult your partner

The first person you need to run the idea past is your birth partner. Many men worry about home births because they feel it’s safer to be near to medical assistance if it’s needed. They may also think that having a baby at home means they’ll have to perform the delivery. Get your partner to tell you his thoughts about it all, and explain as clearly as possible why you feel this is a good idea. He might be more nervous if it’s your first baby. You could also get your midwife to have a chat with him, so she can reassure him about any concerns.

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Don’t keep your birth fears to yourself – talk to your midwife. She will have helped many other mums-to-be through the same worries before.

Talk to your midwife

Once you’ve reached an agreement with the dad-to-be, you need to speak to your midwife about a home birth. You can do it at any appointment; you don’t need to make one specifically.

It’s useful for your midwife to know by 36 weeks if you’re keen to go ahead, so that she can tell her colleagues. However, some women don’t decide it’s what they want until the last minute, and you’re allowed to change your mind at any stage.

Questions you might want to ask your midwife include:

  • What’s the local home birth rate?
  • How many home births have you attended in the past year?
  • Is there a local home birth group where you can talk to other mums who’ve had or are planning a home birth?
  • Is there an opportunity to meet other midwives in the team who might be looking after me in labour?

A midwife can’t ‘refuse’ you a home birth. However, things like staffing problems or the weather might affect whether it can go ahead. If your midwife’s reluctant to support a home birth, you can write to the Head of Midwifery or Supervisor of Midwives and ask for another midwife. However, if she has real concerns that you are not considered ‘straightforward’, it would be advisable to listen to her.

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Drug-free labour or natural birth, the choice is yours

Check your health

There’s no exact list of medical reasons why you would be refused a home birth. However, some women are advised against it, and that can be because of complications during a previous birth, certain medical conditions, or problems during this pregnancy. For example, if you lost a large amount of blood when giving birth previously (postpartum haemorrhage) there’s an increased risk of this happening again and you’d be advised to have your baby in hospital. The same applies if you have previously had a c-section or if there are concerns about very high blood pressure or pre-eclampsia. Where there are worries about your baby’s growth during pregnancy or his wellbeing, you will be advised to be in hospital where paediatricians are on hand immediately after you give birth.

What’s important is that the ‘problems’ are relevant. For example if you’ve had your appendix removed or previously needed help with ventouse or forceps, that doesn’t mean you’re unsuitable for a home birth. In a straightforward pregnancy, the evidence is that home is just as safe as hospital.

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Independent midwives are a common choice for those hoping for a home birth.

Check your finances

Home births are free on the NHS but if you want a guarantee that you’ll know the person who cares for you in labour you might want to consider paying for an independent midwife. (If your NHS midwife is on her day off when you go into labour, a different midwife will attend you.) Midwives who work privately tend mainly to do home births, and provide all the antenatal and postnatal care in your house, too. Prices vary, but expect to pay around £3,000 if you go down the independent route. All midwives can bring pain relief to your home if you need it (not an epidural though) and you won’t receive a bill for the gas and air if you opt for it!

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