Is having a homebirth safe?
Yes! The Birth Place study (www.npeu.ox.ac.uk/birthplace) found that for low risk women having their second or subsequent babies, a homebirth was as safe as giving birth in a maternity unit or an obstetric unit. And a homebirth reduced the likelihood of a women having a caesarean section, instrumental delivery (e.g. forceps) or episiotomy. The NHS recommends homebirth as a safe option for second time low risk mothers.
If you are having your first baby then homebirth is still a safe option although the risks of something not going to plan are higher. However, the likelihood of something going wrong is still relatively low (9.3 per 1000 homebirths compared to 5.3 per 1000 for a hospital birth).
The main reason women planning a homebirth are transferred to hospital during labour is because the mother feels she needed extra pain relief rather than because of a problem with her or her baby.
Is having a homebirth messy? Who cleans up?!
Not as messy as most people imagine! As long as you have few basics such a waterproof cover to put under you while you give birth and a couple of puppy pads/incontinence pads then most of the blood and other bodily fluids can simply be wrapped up afterwards and thrown away. The midwives can take away your placenta once it has been checked if you would like them too, or they can leave it with you if you wish. Any spilled drops of blood can easily be cleaned up using cold water and biological detergent.
If you are having a birth pool you will need to set this up and take it down yourselves (this is often a key role of the birth partner!) If you get a submergible pump with your birth pool kit you can simply drain the water out down a drain/toilet/sink and then throw away the liner. If you don’t have a pump you can make simple syphon with a hose.
A really good protective covering to buy is oil cloth. Its that table cloth material which is plastic on one side and material on the other. They are totally waterproof and are much less crunchy and slippy than a shower curtain (which often aren’t as waterproof as they look!)
I would like to have a homebirth, but where do I start?
A great place to start is by referring yourself to the Leeds Home Birth Team. You can do this directly by any of the contact details on the link below:
You then have two options,
- you can transfer all of your maternity care over to the Home Birth Team (this includes all your antenatal appointments, support during the birth and then all post natal care), or
- you can continue to see your community midwife for your ante and post natal appointments and just receive care from the Home Birth Team for the birth of your baby. It’s your choice depending on what works best for you and your family.
Another alternative is to choose an Independent Midwife to provide some or all of your maternity care. Details of local Independent Midwives can be found here:
Some women choose to have a ‘freebirth’ or unassisted birth for their baby. This is when a woman gives birth without the presence of a medically trained professional. If you want to know more then the Freebirth Society is a good place to start.
I’ve been told I’m high risk, can I still have a homebirth?
It is always your decision! Others may share an opinion or advice but you make the decisions. The term high risk is an unhelpful one as anyone with any identified risk factor is labelled as high risk and there are obviously some circumstances that involve a greater chance of things not going to plan than others.
If you are choosing to birth at home with an identified risk factor then you should be offered an appointment to discuss your plans for the birth with a consultant. You may find it useful to take someone with you to this appointment and ideally your midwife should be there.
If you feel you would like more information or to discuss your plans with someone else you can contact:
- Birthrights (https://www.birthrights.org.uk/factsheets/) a charity who’s aim is to protect human rights in childbirth.
- AIMS – Association for Improvements in Maternity Services (https://www.aims.org.uk/) charity that provides information and advice on making informed choices about birth, including assessing specific risk.
- An Independent Midwife (a qualified and registered Midwife who is not employed by the NHS trust so she can speak without pressure to conform to guidelines.
If you feel comfortable sharing in the group (either in person at our monthly meetings or via our Facebook page) then you may find other women with similar circumstances who can help you find the support you need to make a plan that feels right for you and your family.
Can I change my mind?
Yes! It is much easier to plan for a homebirth and then change your mind and head into hospital than it is to plan for a hospital birth and then decide to stay at home (although of course this is possible). Often the research women do towards planning their homebirth actually helps them to have a more informed hospital birth which they feel more in control of, if they do decide to go into hospital.
What about my other children, can they be around?
Yes! The wonderful thing about being at home is that you make all the choices about what goes on and who is present. Many women birth surrounded by family or birth their babies during the night while their children are asleep. However it’s important to think through your options beforehand. Some women plan to have their children around for the birth but find that when the time comes they just can’t get into the zone with their children there. So having a back up plan for each eventually is always good.
What do I need for a homebirth?
You don’t need a huge amount of equipment or anything fancy to give birth at home. The midwives attending your birth will bring medical equipment with them, as well as gas and air should you wish it. Here are a few things you might like to collect in preparation:
- A birth pool, pool liner, hose, tap adaptors and pump (if you are planning a water birth).
- Something waterproof to give birth on/protect your soft furnishings. A good option is an ‘oil cloth’, one of those table clothes that is plastic on one side and material on the other. Whatever you choose make sure it is totally waterproof (some shower curtains are definitely not!)
- Puppy pads / incontinence pads to sit or lie on.
- Things to keep baby and you warm straight after the birth, big towel or blanket is great, dressing gowns are great for skin to skin!
- Towels for drying when getting out of the birth pool/shower, they are also good for kneeling on and putting under your while your give birth.
- Maternity pads or pants (not sanitary pads).
- Something to be sick into should you need it!
- Something to tie your hair back
- Anything you fancy to create a birthing space (lights, music, aromatherapy etc) however be prepared to potentially abandon your beautifully created birth space in favour of the loo!
- Drinks and snacks you might fancy during labour. Some women like to use a straw or a bottle with a sports lid as it makes drinking easier.
- TENS machine, hot water bottles etc for pain relief.
- Transfer to hospital bag (just in case): change of clothes, maternity pads, lots of knickers, clothes for baby and nappies.
Do I have to have a birth pool?
No, many women find the option of a birth pool a real benefit of birthing at home however birth pools certainly aren’t for everyone. If you think a birth pool might not be for you then there are plenty of other amazing places to give birth around the house like your bed, the sofa, the toilet, the stairs, the landing, basically wherever feels comfortable!
I would like to have a birth pool, how much space do I need?
Not as much space as you might think. Birth Pools usually come in two sizes, around 165x145cm and 193x165cm so as long as you have space in a room for the pool and a bit of movement around it for the midwives or your other birth supporters then you’re good to go! You will need to have access to warm water (obviously) to fill your pool but this can be done using a tap adaptor and a hose pipe so the pool doesn’t have to be right next to the water source. Also consider where you will drain the water out of afterwards. This can be done into a bath or toilet, down a drain or straight onto the garden.
Where can I get a birth pool from?
- We are very lucky in Leeds to have the Leeds Community Birth-pool Hire Scheme which you can access via their Facebook page. They are a volunteer run scheme which hires out birth-pools at an extremely reasonable price. They do get booked up quickly so contacting them with your dates early on is really important.
- You can buy a new birth pool for around £150 from various companies. You will need to buy other accessories as well such as hose, tap adaptors, liner etc.
- You could buy a second hand pool from a selling site (just make sure you do a test run and buy a new liner).
- Many companies also do pool hire for around £95, which is likely to include all the kit.
- Ask on the Leeds Homebirth Support Group Facebook page as often people are happy to pass on their kit once they’ve finished with it.
Always do a test run to make sure everything in full working order before the big day. And always use a new pool liner.
What pain relief can I have at home?
You can have the usual paracetamol at home and if you speak to your midwife you can also get a prescription for dihydrocodine which is a stronger pain medication which can be taken in the early stages of labour. The midwives can also bring gas and air with them for you to use. Many women find a Tens machine helpful during labour and also techniques such as hypnobirthing can be very effective. The difference between a home and hospital birth is that at home it is much easier to move around freely and get into comfortable positions etc so for many women the whole experience of being at home, and being relaxed, actually helps them manage the surges much better.
How many midwives will I have at my homebirth?
The aim is for you to be supported by two midwifes during your labour and birth. It might be that two midwives arrive at the start together or that you are assessed by one midwife who is then joined later by a second midwife. If your labour is long or crosses over a shift change then you will be supported by two new midwives who will be introduced to you by your current midwives. Sometimes student midwives are available to attend and it is your decision if you agree to them being there or not.
How long will the midwives stay with me after the birth?
The midwives will usually stay for a few hours after the birth. They will support you to birth your placenta, carry out the early baby checks, do any stitches that may be required (although sometimes it may be suggested that you transfer to hospital for stitches), help with the clear-up and get you settled on the sofa or in bed with your new baby. They will only leave once you feel ready.
Will I still get help with breastfeeding?
Yes, if you would like to breastfeed it is really important to give your baby a chance to latch soon after the birth. The first hour after birth is a great time to get this going, especially while you are doing skin to skin. The midwives can support you with this and should protect this time for you. You will also receive further home visits from your midwife in the days after your baby is born so you can get help with breastfeeding then too. If you feel you need additional support with breastfeeding or are finding it painful or difficult, speak to your midwife and ask for additional help.
What happens if I need to transfer to hospital? Who can come with me?
Transferring to hospital is when you decide to move the place where your baby is born from your home to the hospital. This can be done at any stage of the labour and could be done for a number of reasons such as
- You no longer feel comfortable birthing at home
- You would like additional pain relief which is only available in hospital
- You or your midwife have concerns that your labour is not going as planned
- You or your baby become unwell or might need additional support.
Your midwife will discuss the options with you and together you can make an informed decision about the best way to proceed. Women who do decide to transfer can go to hospital in their own car (driven by someone else!) or an ambulance. This will depend on how far the labour has progressed and the reason for transferring. It is always your decision whether you transfer to hospital or not and in the vast majority of cases transfer is done as a non-emergency.
Your birth partner will usually be allowed to transfer with you and you will be supported by your midwives on the way to hospital and often once you are there as well. If you have concerns about this it is worth discussing the options with a member of the homebirth team at one of your antenatal appointments.
My partner/family aren’t happy about the idea, how can I help them understand my wishes?
As birthing at home still isn’t the norm in the UK, there’s lots of misinformation and hearsay about it and partners and family may be concerned about your choice. It could be really helpful for your partner to talk to a midwife on the Homebirth Team about their concerns or to go along to a Homebirth information session. Linking them to information can be really helpful too.
It can be very tiring and upsetting to keep having to justify your choice to have a homebirth. Some people choose not to tell anyone who they think might be unsupportive. This can help limit the amount of negative feedback given.
Ultimately where you give birth is your choice, and no one cares more about your baby’s welfare than you do.
We hold Homebirth meetings on the second Sunday of each month and these are a great place to hear Homebirth stories, meet other homebirth parents and talk though any questions and concerns. Partners, friends, family members and children are all welcome.
I’ve been told I’m having a big/small baby, does this mean I can’t have a homebirth?
It’s always your decision whether to accept or decline any offers of intervention. If you have been told there is a concern with baby but you don’t agree, or if you feel like you’ve not had enough information you can always ask to see your midwife or a midwife from the Homebirth Team to discuss it. If you’d like to speak to a midwife not employed by an NHS trust you can contact an Independent Midwife for a one off appointment, or you can contact the AIMs charity helpline.