Birth options: where to give birth?

In the UK, the national average of home birth rates are 2.4%. However, this varies tremendously regionally. Some places have a lower rate and some much higher. Wales for example has a homebirth rate of 3.7%, whilst Northern Ireland has a rate of 0.3%. Many NHS hospitals have a dedicated home birth team with midwives specialising in home birth and supporting mums to birth safely at home. Similarly, there are private, independent midwives who offer homebirth services around the country.

If you are considering a homebirth, you might want to start by speaking with your maternity care provider to find out whether the service is offered locally. Most NHS trusts do offer homebirth services, but occasionally, some do not.

If you decide on a home birth, you will be referred to the homebirth team where a midwife will help you to make a detailed plan. When you go into labour, a midwife will attend to your home, usually backed up by another midwife close to the time of birth. This is so that one midwife can tend to you, and another for the baby after the birth. At some point a midwife may visit you at home to make sure you have a suitable space for a homebirth, noting any stairs in flats, parking, and space for birthing pools. They will also give you a list of items that you will need to purchase in preparation.

There are a few things to keep in mind when it comes to home births. In some circumstances you may need to transfer to a hospital; your midwife will give you information about this but it’s very rarely due to an emergency.

Your pain relief options are more limited at home – in most cases, gas and air is the main pain relief on offer. You can of course, use a TENS machine if you have one, along with hypnobirthing and other relaxation techniques to help you through labour.

In some situations, your midwife might advise against a home birth:

If you're not keen on hospital, but don't feel confident opting for a home birth, you might want to consider a birth centre. Birth centres can be part of a hospital or stand-alone units. They tend to offer a more homely atmosphere than a hospital ward.

Midwives often recommend birth centres for those with uncomplicated pregnancies. These centres provide a more relaxed environment than hospital wards, often including water birth pools, and typically offer positive experiences and outcomes for expectant mothers. If you have a low risk pregnancy, you may be automatically referred to a birthing centre to have your baby.

Birth centres are staffed by midwives, not doctors, so women giving birth here are less likely to have medical interventions like a forceps delivery. If you need an intervention, your midwife will transfer you to the nearest maternity hospital or the labour ward.

If your centre isn't part of a hospital, however, you might not be able to opt for an epidural for pain relief, so it's worth checking this with your midwife beforehand. If an epidural isn’t available but you later request one, you will need to be transferred to a labour ward within a maternity unit. You may find that in your local hospital, the birth centre and labour ward are sitting very close together, making a transfer easy.

If you're interested in using a birth centre, you can ask your community midwife if there are any in your area. Even if there are not, many hospitals now offer similar units as part of their maternity care.